Magnetic resonance imaging findings in bipartite medial cuneiform – a potential pitfall in diagnosis of midfoot injuries: a case series

Ilan Elias,Steven M Raikin,Sachin Dheer,Adam C Zoga,William B Morrison

doi:10.1186/1752-1947-2-272

Abstract

IntroductionThe bipartite medial cuneiform is an uncommon developmental osseous variant in the midfoot. To our knowledge, Magnetic Resonance Imaging (MRI) characteristics of a non-symptomatic bipartite medial cuneiform have not been described in the orthopaedic literature. It is important for orthopaedic foot and ankle surgeons, musculoskeletal radiologists, and for podiatrists to identify this osseous variant as it may be mistakenly diagnosed as a fracture or not recognized as a source of non-traumatic or traumatic foot pain, which may sometimes even require surgical treatment.Case presentationsIn this report, we describe the characteristics of three cases of bipartite medial cuneiform on Magnetic Resonance Imaging and contrast its appearance to that of a medial cuneiform fracture.ConclusionA bipartite medial cuneiform is a rare developmental anomaly of the midfoot and may be the source of midfoot pain. Knowledge about its characteristic appearance on magnetic resonance imaging is important because it is a potential pitfall in diagnosis of midfoot injuries.

Highlights

The bipartite medial cuneiform is an uncommon developmental osseous variant in the midfoot
Knowledge about its characteristic appearance on magnetic resonance imaging is important because it is a potential pitfall in diagnosis of midfoot injuries
Orthopaedic foot and ankle surgeons, musculoskeletal radiologists and podiatrists should be aware of this osseous variation as it may be mistakenly diagnosed as a fracture and recognize that a bipartite medial cuneiform may be a cause of a non-traumatic or traumatic midfoot pain that may sometimes even require surgical treatment [2,3]

Summary

Conclusion

A bipartite medial cuneiform is a rare developmental anomaly of the midfoot and has a characteristic appearance on MRI (E-Sign). Knowledge of the presence and appearance of this osseous variant is important in being able to identify this entity and to differentiate it from a fracture because this may potentially be a pitfall in diagnosis of midfoot injuries. Even in the absence of a fracture, a bipartite medial cuneiform may be the source of midfoot pain, which can be treated with various techniques, including surgery [3]

Introduction

Discussion

Findings

Barlow TE