Outside radiographs and MRI Case Photo #1 showed marrow edema in the proximal moiety of her tibial sesamoid. There was no evidence of sclerosis or flattening. Findings were consistent with sesamoiditis, contusion, or chronic repetitive microtrauma. Supporting ligaments and tendons of the foot and ankle were reported as intact.
Diagnostic ultrasound examination revealed a small, non-hyperemic first metatarsophalangeal joint effusion with chronic synovial hypertrophy Case Photo #2and bipartite, non-diastatic tibial sesamoid bone with intact intersesamoid ligament and cartilage of the metatarsophalangeal joints Case Photo #3. Typical sesamoid pain was reproduced on sonographic palpation of her forefoot and great toe Case Photo #4. The medial hallucal nerve was non-neuromatous in appearance, but hypersensitivity on sonographic palpation was suspicious for medial hallucal nerve irritation Case Photo #5.
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