The Lisfranc ligament, which extends from the plantar aspect of the medial cuneiform to the base of the second metatarsal, is a prime stabilizer of the medial and middle columns.
It is believed that while bony injury is common among ballerinas, involvement of the adjacent Lisfranc ligament is rare, despite the significant amount of force experienced at the base of the second metatarsal.
MRI is remarkably useful for depicting soft tissue detail and allowing direct visualization of the Lisfranc ligament, but it is a static test that may not identify the often subtle dynamic instability frequently associated with Lisfranc joint disruption.
3) facilitates visualization of the space between the second metatarsal and medial cuneiform, allowing for direct visualization of displacement secondary to Lisfranc ligament injury.
There are two classification systems of Lisfranc ligament injuries that are commonly used: the Myerson system (not shown), which focuses on distinguishing displacement patterns, and the Nunley and Vertullo system (Table 2), which applies more subtle radiographic findings of midfoot sprains.
Caption: Figure 1: Two consecutive axial T2 fat saturated images (TR: 2917, TE:93) at 1.5 Tesla demonstrate indistinctness of the Lisfranc ligament (arrow in A) with surrounding edema.
The midfoot sprain: a review of Lisfranc ligament injuries.