51M s/p MVA May 24 with suspected Rt sesamoid fracture, XRs both feet


This is an asymptomatic comparison

The medial sesamoid appears to be fractured / fragmented

I was all set to diagnose Turf Toe…based on the widening of the medial and lateral sesamoid – phalanx distance (medial is 9-9.5 mm and lateral is 11-11.6mm), but it seems that the distance is bilaterally increased and pretty symmetric

How to explain this?

What to recommend? Is there a reason to recommend Rt forefoot MRI or US?
It’s a personal injury case….I wouldn’t ordinarily image an asymptomatic foot..but they routinely image so many asymptomatic body parts after personal injury—would you recommend Left forefoot MRI to sort this out?

Hilary

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