Imaging Case of the Week 419 Answer

The left foot AP view shows a widened joint space between the bases of 1st & 2nd metatarsals. This is Lisfranc joint and may indicate the presence of a Lisfranc fracture dislocation in the context of trauma.

With above suspicion, patient went on to have a comparative weight bearing views of both feet, which showed symmetric appearance of inter space between 1st & 2nd metatarsals.

A weight bearing comparative views of both feet is something to think about when Lisfranc injury is suspected but mechanism is not significant and clinical examination does not reveal significant features of swelling or tenderness.

Further details on Lisfranc fracture dislocation can be found here