I had a leg injury 20 days back, please explain my MRI reports.

Question

Hello doctor,

I am a 33-year-old male, who presents with a Lisfranc injury. I had a leg injury 20 days back. I was told it was a minor sprain, and I tried to walk on my foot, but it is paining a lot. I am currently using non-weight-bearing boots, and would not be able to see my surgeon for another six days. I got an MRI of the leg, can you please make me understand the findings? The MRI reads, both the dorsal and plantar bundles of Lisfranc ligaments are intact and normal in appearance. The first and second TMT joints are normal. There has been a capsular injury involving the dorsal aspect of the fourth TMT joint. Edema overlies the dorsum of the foot in this region. There is no associated fracture demonstrated. Mild edema is also seen in the adjacent cuboid at its articulation with the fifth metatarsal. The third TMT joint is normal and the shafts of the metatarsals are normal. The navicular cuneiform joint complex is normal. The extensor tendons are well maintained and the flexor tendons are intact. Capsular injury involving the dorsal aspect of the fourth TMT joint with adjacent bone contusions and intact Lisfranc ligament. I was wondering, after reading this, what should I expect at my next appointment with the surgeon. Will I require a cast? I also do not understand what any of this means. Thank you.

Answer 1

Hello doctor,

Welcome to icliniq.com.

You mentioned an injury to your foot around 20 days back, which has been managed conservatively till now. Having read your description, it appears that there has been a capsular injury at the tarsometatarsal joints, especially, the fourth and fifth joints with associated mild edema. Also, there is no bony injury or any subluxation of the joint. The management is simple, I suggest either a walking cast or a pneumatic walker needs to be put so that soft tissues can heal satisfactorily. This may take 3 to 4 weeks but can take sometimes slightly longer, and the same management needs to continue till pain and swelling subside. You can take an anti-inflammatory medication as per your requirement along with some medicine to keep the swelling down. Also, avoid any sports till your symptoms completely subside. Also, physical therapy needs to be initiated so as to prevent stiffness. I hope I have answered your questions and doubts.