Chapter 6 - Joints

Plantar plate of the 2nd MPJ is adhered, causing alteration of the metatarsal phalangeal joint mechanics. Additionally the plantar plate is being compromised by the base of the proximal phalanx.

Note as the toe is dorsiflexed and the sesamoid moves distally it covers and eliminates the cortical outline of the metatarsal head due to an acoustic artifact. (The sesamoid is blocking the ultrasound waves from striking the metatarsal head.)

This video shows the tear. However, when the probe is moved to a different position on the plantar aspect of this joint the ligament is intact. If totally ruptured the joint will dislocate.

The plantar plate does not glide under the metatarsal head.

Plantar plate is not present.

Note as the toe is dorsiflexed and the sesamoid moves distally it covers and eliminates the cortical outline of the metatarsal head due to an acoustic artifact. (The sesamoid is blocking the ultrasound waves from striking the metatarsal head.)

Note the abnormal range of motion. The phalanx distracts rather than glide around a central axis. Clinically this joint appears to have a range of dorsi and plantar flexion.

Synovitis has echo in contrast to an effusion which is usually anechoic.

Distraction of joint during a range of motion due to the lack of gliding of the plantar plate.