PMC9716223_01
Lateral and dorsoplantar view of the right metatarsus showed mid-diaphyseal, well delineated, horizontal lysis of metatarsals 2-5, with ovoid, discrete geographic lysis of metatarsals 2 and 5. Smoothly marginated new bone is seen on the lateral aspect of metatarsal 5 and the plantar aspect of the metatarsals on the lateral view. Moderate soft tissue swelling was noted surrounding the lucencies with a subtle dorsal indentation of the soft tissues (arrow) at the level of the boney lysis best seen on the lateral view.
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F1
A dorsoplantar and lateral radiograph of the right tarsus and metatarsals were taken (Figure 1).
(A) Preoperative ultrasound image showed a horizontally oriented hyperechoic band (arrows) along the plantar aspect of the limb deep to the flexor tendons and superficial to the metatarsal bones. (B) Intraoperative ultrasound along the same imaging plane demonstrates the absence of foreign material.
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F2
A brief ultrasound of the metatarsal swelling was done (Toshiba Aplio 500 Machine, 18-7 MHz linear probe), which showed a hyperechoic linear structure along the plantar soft tissues and dorsally between the metatarsal bones (Figure 2A). Intra-operative ultrasound was performed (Figure 2B), using the same ultrasound machine with the 18-7 MHz linear probe, and no further foreign material was identified.
Multiplanar reformatted images of the computed tomographic in a bone window showed soft tissue swelling noted along the plantar aspect of the metatarsal bones (arrows). In this region, there were well-defined smoothly marginated lucencies that appeared to tunnel horizontally through all metatarsal bones (arrows). Adjacent sclerosis and smoothly marginated new bone were noted along the metatarsal bones in this region.
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F3
Poznan, Poland; https://www.radiantviewer.com/) (Figure 3). Post-contrast images were acquired after intravenous administration of 58 ml of Iopamidol (Isovue 370) via an intravenous catheter (Figure 4).
On the post-contrast multiplanar computed tomographic images obtained in a soft tissue window, the non-contrasting tubular structure (arrow) appeared to be adjacent to a soft tissue tract with mild contrast enhancing walls dorsomedial to the 2nd metatarsal bone (curved arrow). There was strong contrast enhancement surrounding a non-contrast enhancing tubular structure (arrows) which circumferentially coursed through the areas of bone lucencies and soft tissues and continued along the plantar region between the interosseous muscles and the flexor tendons. The flexor tendons appeared indistinct in this region.
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F4
Poznan, Poland; https://www.radiantviewer.com/) (Figure 3). Post-contrast images were acquired after intravenous administration of 58 ml of Iopamidol (Isovue 370) via an intravenous catheter (Figure 4).