Fig. 2. Degeneration of the navicular bone. Sagittal proton density image of the foot (A) showing sclerosis (green arrow) and a palmar flexor cortical erosion (red arrow) and gradient echo transverse image of the foot (B) showing a palmar flexor cortical erosion (red arrow).
Soft-Tissue Abnormalities
Deep Digital Flexor Tendonitis/Tendonopathy Injuries of the DDFT are common and can occur in single or multiple locations within the foot (Fig. 4). Severity, location, and type of lesions are critical to determine the most appropriate treatment option and prognosis. The type of damage to the DDFT can be manifested in many ways, including sagittal splits, core lesions, dorsal fibrillation, diffuse disease, and generalized enlargement. Based on clinical impres- sion, a common location for tendinosis/tendonitis is at the proximal recess of the navicular bursa, with or without extension proximal into the digital flexor ten- don sheath. In addition, sagittal splits at the level of
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Fig. 3. Subchondral bone/cartilage abnormality. Dorsal gradi- ent echo image of the foot (A) showing a subchondral cyst in the distal phalanx (red arrow) and dorsal proton density image of the foot (B) shoeing an articular cartilage and subchondral bone injury within the pastern (red arrows).
the navicular bone, insertional injuries at the attach- ment of the DDFT onto the palmar/plantar solar mar- gin of the coffin bone, and significant extension of tendonitis into the digital flexor tendon sheath are also common locations of damage. The severity/chronicity of lesions is largely based
on the signal intensity. It is largely accepted that lesions with high signal intensity on proton
