The plantar plate of the lesser metatarsophalangeal joints: Potential for injury and role of MR imaging

Forefoot MR imaging has not been commonly performed but can permit optimal evaluation of the plantar plate, collateral ligaments, and flexor tendons in the assessment of metatarsalgia with or without associated instability and toe deformity. High-resolution images can be achieved by imaging the forefoot in a quadrature wrist coil. Contiguous thin-section 2D-GRE coronal images through the forefoot ideally delineate the position and integrity of the plantar plate, as well as the status of the collateral ligaments and flexor tendons. As an adjunct to weight-bearing AP radiographs, which are useful for detection of arthritis, fracture and osteonecrosis, and hallux valgus and second metatarsal protrusion, MR imaging provides useful information to guide conservative or surgical management and improve clinical outcome.