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Skeletal Radiology
Published in: Skeletal Radiology 1/2020

01-01-2020 | Magnetic Resonance Imaging | Review Article

Imaging in Lisfranc injury: a systematic literature review

Authors: Yantarat Sripanich, Maxwell W. Weinberg, Nicola Krähenbühl, Chamnanni Rungprai, Megan K. Mills, Charles L. Saltzman, Alexej Barg

Published in: Skeletal Radiology | Issue 1/2020

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Abstract

Objectives

To systematically review current diagnostic imaging options for assessment of the Lisfranc joint.

Materials and methods

PubMed and ScienceDirect were systematically searched. Thirty articles were subdivided by imaging modality: conventional radiography (17 articles), ultrasonography (six articles), computed tomography (CT) (four articles), and magnetic resonance imaging (MRI) (11 articles). Some articles discussed multiple modalities. The following data were extracted: imaging modality, measurement methods, participant number, sensitivity, specificity, and measurement technique accuracy. Methodological quality was assessed by the QUADAS-2 tool.

Results

Conventional radiography commonly assesses Lisfranc injuries by evaluating the distance between either the first and second metatarsal base (M1-M2) or the medial cuneiform and second metatarsal base (C1-M2) and the congruence between each metatarsal base and its connecting tarsal bone. For ultrasonography, C1-M2 distance and dorsal Lisfranc ligament (DLL) length and thickness are evaluated. CT clarifies tarsometatarsal (TMT) joint alignment and occult fractures obscured on radiographs. Most MRI studies assessed Lisfranc ligament integrity. Overall, included studies show low bias for all domains except patient selection and are applicable to daily practice.

Conclusions

While conventional radiography can demonstrate frank diastasis at the TMT joints; applying weightbearing can improve the viewer’s capacity to detect subtle Lisfranc injury by radiography. Although ultrasonography can evaluate the DLL, its accuracy for diagnosing Lisfranc instability remains unproven. CT is more beneficial than radiography for detecting non-displaced fractures and minimal osseous subluxation. MRI is clearly the best for detecting ligament abnormalities; however, its utility for detecting subtle Lisfranc instability needs further investigation. Overall, the available studies’ methodological quality was satisfactory.
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Metadata
Title
Imaging in Lisfranc injury: a systematic literature review
Authors
Yantarat Sripanich
Maxwell W. Weinberg
Nicola Krähenbühl
Chamnanni Rungprai
Megan K. Mills
Charles L. Saltzman
Alexej Barg
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 1/2020
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-03282-1

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