Plantar plate tears part 2

Plantar plate tears part 2/ In the last segment we discussed what is the plantar plate and what plantar plate tears are. In this post I will discuss how are Plantar plate tears diagnosed and get into the treatment options.

Many people will come in with pain in the balls of their feet and the doctor will quickly diagnose a mortons neuroma. The error in that is that there are many other diagnosis besides that which have a totally different treatment. The exam done is called a modified Lachmans test where i can feel if the second metatarsal phalangeal joint 9 which is by the ball of the foot under the second toe if there is a instability or mild subluxation i would go on to do an x ray.

Plantar plate dislocation

The x ray will NOT be able to diagnose a plantar plate tear . However it will be able to rule out a stress fracture of the second metatarsal. Also it can give us an insight if one has a long second metatarsal which can us an insight into the foots biomechaniccs and can be a precursor to a plantar plate tear. This is what differentiates going to a shoe or running store and getting a pair of orthotics off the shelf , they can not do an x ray to see whats happening. Once the x ray is negative for stress fractures that is where the next step comes in . I order an MRI arthrogram. The procedure that is performed is a common procedure for hip and shoulder capsules. A dye is injectes into the joint , if the dye leaks out the capsule is torn- in our case the capsule of the second metatarsal phalangeal joint (MPJ).