HSS Ultrasound of the Month Case 143

Clinical History 51 year old male with chronic pain over the medial aspect of the midfoot.

Ultrasound of the Month – Case 143

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Ultrasound of the Month – Case 143

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Ultrasound of the Month – Case 143

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Diagnosis: Bipartite Medial Cuneiform Bipartite medial cuneiform is a rare developmental variant, occurring in less than 1% of the population, in which the medial cuneiform forms as two separate bony components instead of a single bone.

The two components, dorsal and plantar, may be united by a synchondrosis, syndesmosis, or combination of the two.

Bipartite medial cuneiform may become a source of pain in adults.

Bone marrow edema on MRI is a clue that it may be the source of the patient’s pain.

Ultrasound-guided anesthetic injection may be useful for confirming the source of patient’s foot pain.

Treatment for bipartite medial cuneiform is usually conservative, but patients with persistent pain may require an arthrodesis.

Ultrasound of the Month – Case 143

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