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What we're gonna do today is have sort

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of a two-part session.

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First, we're gonna really dig into the anatomy.

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Um, the first case is just a normal forefoot MRI

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and just wanna go over some of the important things to look

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for structures that I use in my search pattern, um,

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pathologies that I look for.

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And then we'll start going through a few cases

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and, um, see some common pathologies

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that they're gonna see in practice.

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And I have the, uh, chat bar open, um, for questions.

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So please feel free to ask questions as we go along.

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What I'll do is I'll go through a case or so,

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and then I'll try to answer the questions after that.

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So first, um, let's go in here

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and, um, look at this normal foot, uh, MRI.

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So, um, what you can see is that, um, when you, uh,

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image the forefoot, um, first

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of all, what are we talking about?

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We're talking about, um, really from the tips of the toes

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to sort of the midfoot.

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Um, the hind foot

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or ankle would be more the, just the hind foot to the,

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the tars metatarsal joints.

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Um, if you, uh, image the entire foot in one field

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of view from the heel all the way to the tips of the toes,

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the only issue with that is that you sort

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of have a very zoomed out view of the whole foot.

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In pediatrics, sometimes we do like that

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because, uh, we can just get a lay of the land.

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Um, but for most, uh, imaging, adult imaging

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and, uh, once you're a teenager,

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so you really wanna have a zoomed in kind of small foot

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of you over just the forefoot alone in order to be able

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to make good diagnoses.

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So when you think of the protocol,

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of course you want three planes.

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Um, you want a short axis, a long axis, and a sagittal.

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Um, there's a variety of ways to do it here.

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Um, in this, uh, particular, uh, example, we're scrolling

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through a long axis, T two, um, turbos echo image.

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So this does not have fat suppression.

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It depends on what region you are practicing, uh, in.

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Um, I do also like to have a fat suppressed image in general

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to assess for bone marrow edema.

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But let's just, uh, go ahead

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and start here looking at the forefoot.

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So first thing is just to kind of get familiarize yourself

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with the, um, bone anatomy.

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So when you look here from the proximal aspect,

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what we're gonna see is the midfoot bones.

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So, um, depending on your exact field of view, um,

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you're gonna see the, um, tarsal bones here.

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So I'm gonna minimize this thing here

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so you guys don't have to see that.

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And I'm also going to, um, rotate this here.

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When you look here, you see the, um, navicular bone, uh,

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and it's gonna have a large kind of articulation

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with three other bones.

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Here you have the medial QA formm, the intermediate

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or middle QA, formm, and the lateral QA formm.

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So forming the navio qa, formm articulation,

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you're gonna have the cuboid here in part of the field

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to view.