Abstract
Introduction
Literature in respect to the MRI appearances of surgically confirmed spring ligament pathology is sparse. The authors conducted a retrospective review of MRI examinations comprising 13 patients with surgically proven spring ligament abnormality.
Methods
Records for operations performed for planovalgus foot deformity with operation notes confirming presence of spring ligament abnormality were obtained for patients treated 2010–11. Of 32 procedures 13 patients (3 male, 10 female) mean age 48.5 (range, 21–86 years) underwent preoperative MRI scanning using a standard musculoskeletal protocol on a T1.5 unit. Scans were retrospectively reviewed by one of the senior authors and consultant musculoskeletal radiologist for pathological findings.
Results
The superio-medial portion of the ligament was abnormal in all 13 scans, most common pathological findings were: thickening of the ligament proximally (>5mm) with distal thinning (< 2mm). Global thickening was confirmed on 1 scan as abnormal with a final abnormality on 1 scan of high signal change at the navicular insertion representing a linear tear. The medio-plantar portion demonstrated less consistent abnormal findings: 5 scans demonstrated high midsubstance or navicular insertion signal change. Abnormal widening of 7–9.5mm was noted in 4 scans, thinning and loss of striations was reported in 2 scans. For the final 2 scans no abnormality was detected.
Conclusion
The most consistent abnormal finding representing spring ligament pathology in this series was thickening/bunching of the superior-medial portion of the ligament >5mm and thinning/absence of the ligaments insertion into the navicular distally (one or more of these features were present in 85% of confirmed ruptures). Our series concurs with the current literature in that surgically significant pathology of the spring ligament complex is best demonstrated in the superior-medial portion on proton density fat-saturated axial cuts, surgeons and radiologists should focus on this sequence for the detection of surgically relevant spring ligament abnormality.
