Dear all. Several people responded. Thank you for your responses. Based on the inputs I thought it was probably "tug lesion" See below, Hilary’s response. Since the other findings were missing, pulley lesions was not my first choice. Would be unusual for a stress fracture.
Some interesting suggestions as follows, unedited.
Conclusion on cuboid pulley lesions: MRI of the ankle rarely but clearly shows cuboid pulley lesions, which themselves are not likely to cause localized pain, and cuboid pulley lesions show significant associations with peroneal tenosynovitis, Achilles enthesitis, and clinically diagnosed inflammatory arthritis.
Subentheseal bone marrow oedema secondary to P Longus tendinosis. there is a small cartilaginous enthesis on the cuboid side as the PL tendon courses underneath it
I think it can be a tug lesion at the insertion of the short plantar ligament. Nothing to do with the P Longus without tenosynovitis. Nothing to do with the FHB.
I’d consider cuboid pulley lesion based on location. https://ajronline.org/doi/full/10.2214/AJR.17.19497
Can be a friction syndrome from cuboid tunnel even if p longus looks normal. https://pubmed.ncbi.nlm.nih.gov/15937710/
Have seen stress injuries distal/ medial to the pulley in dancers and other athletes. Could potentially be this. https://ajronline.org/doi/full/10.2214/AJR.17.19497
Hard to say but I wonder about a cuboid pulley lesion here? Basically mechanical stress response. Although tendon looks alright. Doesn’t seem neoplastic or infectious.
On Mon, Jan 29, 2024 at 5:42 PM :
21 year female. History of injury on 1-8-24. Not specified. Runner.
This is a strange location of BME at the cuboid. Thought? Does not look like stress fracture. Strange for stress fracture Tug lesions? The Perneous longus is intact. Flexor hallucinations brevis tear? Does not look like to me.
