Este sitio está destinado exclusivamente a las profesiones médicas. El uso de este sitio se rige por nuestras Condiciones de servicio y Declaración de privacidad, que puede consultar haciendo clic en los enlaces. Por favor, acéptelas antes de continuar en el sitio web.
WEIGHT BEARING X-RAY FOR LISFRANC INSTABILITY
Why weight-bearing views matter for Lisfranc joint injury
- Early diagnosis of Lisfranc instability is crucial to prevent premature osteoarthritis in the mid foot.
- Subtle instability patterns can be very difficult to identify on x-rays.
- Plain radiographs may not effectively identify instability at the Lisfranc joint, especially on non-weight-bearing views.
- Weight-bearing x-rays are important as they reveal subtle differences between the injured and uninjured sides.
- However, weight bearing may not be possible in the acute phase due to pain.
If you find this helpful, please subscribe to the channel.
Assessing Instability on Weight-Bearing X-Ray
Look for lateral displacement of the second metatarsal in relation to the intermediate cuneiform on weight-bearing radiographs. A step-off of more than 3mm is abnormal.
Measure the distance between the medial cuneiform and the base of the second metatarsal on weight-bearing radiographs. A distance of more than 2.1mm is abnormal.
- Comparison views of the contralateral foot are also very useful.
- Do both non-weight-bearing and weight-bearing comparison views.
- Subtle instability and widening can be easier to recognize when there is a direct comparison with the normal side.
Key Point
- Weight-bearing radiographs provide greater reliability in diagnosing Lisfranc instability compared to non-weight-bearing views, revealing subtle differences between the injured and uninjured sides.
- A C2–M2 step-off of more than 3mm between the second metatarsal and the intermediate cuneiform suggests instability.
- A C1–M2 distance of more than 2.1mm between the medial cuneiform and the base of the second metatarsal suggests instability.
- Comparison views of the contralateral foot, both weight-bearing and non-weight-bearing, help identify subtle instability.
- Early diagnosis is important to prevent premature osteoarthritis developing in the mid foot.
Test Yourself on Some Common & Frequently Asked Questions
Plain radiographs may not effectively identify instability at the Lisfranc joint on non-weight-bearing views. Weight-bearing x-rays reveal subtle differences between the injured and uninjured sides that non-weight-bearing views can miss.
A step-off of more than 3mm between the second metatarsal and the intermediate cuneiform on weight-bearing radiographs.
A distance of more than 2.1mm between the medial cuneiform and the base of the second metatarsal on weight-bearing radiographs.
Subtle instability and widening can be easier to recognize when there is a direct comparison with the normal, uninjured side, ideally with both weight-bearing and non-weight-bearing views.
Early diagnosis is crucial to prevent premature osteoarthritis developing in the mid foot.
VIEW VIDEO: WEIGHT BEARING X-RAY LISFRANC INSTABILITY
If you wish to watch the video in language other than English, please view it on our YouTube Channel HERE
- Join our WhatsApp RadEdAsia community for regular educational posts at this link: https://bit.ly/radedasiacommunity
- Get our weekly email with all our educational posts: https://bit.ly/whathappendthisweek







