Semin Musculoskelet Radiol 2016; 20(02): 154-166
DOI: 10.1055/s-0036-1581118
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Tumors and Tumor-like Abnormalities of the Midfoot and Forefoot

Victor Longo
1   Department of Radiology, University of Michigan, Ann Arbor, Michigan
,
Jon A. Jacobson
1   Department of Radiology, University of Michigan, Ann Arbor, Michigan
,
Qian Dong
1   Department of Radiology, University of Michigan, Ann Arbor, Michigan
,
Sung Moon Kim
1   Department of Radiology, University of Michigan, Ann Arbor, Michigan
› Author Affiliations
Further Information

Publication History

Publication Date:
23 June 2016 (online)

Abstract

The differential diagnosis for a midfoot or forefoot mass or mass-like abnormality includes several common benign and malignant pathologies. Evaluation with imaging can often provide a diagnosis, or at least several likely etiologies, and guide management. Determining if a mass is cystic or solid with ultrasound or MRI can limit the differential diagnosis. Identifying the abnormality at a specific anatomical site, such as a bursa, peripheral nerve, plantar aponeurosis, or tendon, can often suggest a correct diagnosis. Correlation with radiography is essential to determine potential osseous origin or involvement and further characterize matrix mineralization. Imaging evaluation can effectively characterize a mass or mass-like abnormality of the midfoot or forefoot, which can provide a precise or limited differential diagnosis and guide further management for biopsy or other treatment.

 
  • References

  • 1 Ashman CJ, Klecker RJ, Yu JS. Forefoot pain involving the metatarsal region: differential diagnosis with MR imaging. Radiographics 2001; 21 (6) 1425-1440
  • 2 Llauger J, Palmer J, Monill JM, Franquet T, Bagué S, Rosón N. MR imaging of benign soft-tissue masses of the foot and ankle. Radiographics 1998; 18 (6) 1481-1498
  • 3 Van Hul E, Vanhoenacker F, Van Dyck P, De Schepper A, Parizel PM. Pseudotumoural soft tissue lesions of the foot and ankle: a pictorial review. Insights Imaging 2011; 2 (4) 439-452
  • 4 Walker EA, Song AJ, Murphey MD. Magnetic resonance imaging of soft-tissue masses. Semin Roentgenol 2010; 45 (4) 277-297
  • 5 Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ, Walker EA. Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics 2008; 28 (5) 1493-1518
  • 6 Ganguly A, Aniq H, Skiadas B. Lumps and bumps around the foot and ankle: an assessment of frequency with ultrasound and MRI. Skeletal Radiol 2013; 42 (8) 1051-1060
  • 7 Manaster BJ. Soft-tissue masses: optimal imaging protocol and reporting. AJR Am J Roentgenol 2013; 201 (3) 505-514
  • 8 Ortega R, Fessell DP, Jacobson JA, Lin J, Van Holsbeeck MT, Hayes CW. Sonography of ankle ganglia with pathologic correlation in 10 pediatric and adult patients. AJR Am J Roentgenol 2002; 178 (6) 1445-1449
  • 9 Petscavage-Thomas JM, Walker EA, Logie CI, Clarke LE, Duryea DM, Murphey MD. Soft-tissue myxomatous lesions: review of salient imaging features with pathologic comparison. Radiographics 2014; 34 (4) 964-980
  • 10 Kim HK, Kim SM, Lee SH, Racadio JM, Shin MJ. Subcutaneous epidermal inclusion cysts: ultrasound (US) and MR imaging findings. Skeletal Radiol 2011; 40 (11) 1415-1419
  • 11 Yuan WH, Hsu HC, Lai YC, Chou YH, Li AF. Differences in sonographic features of ruptured and unruptured epidermal cysts. J Ultrasound Med 2012; 31 (2) 265-272
  • 12 Horton LK, Jacobson JA, Powell A, Fessell DP, Hayes CW. Sonography and radiography of soft-tissue foreign bodies. AJR Am J Roentgenol 2001; 176 (5) 1155-1159
  • 13 Zanetti M, Strehle JK, Zollinger H, Hodler J. Morton neuroma and fluid in the intermetatarsal bursae on MR images of 70 asymptomatic volunteers. Radiology 1997; 203 (2) 516-520
  • 14 Bowen CJ, Culliford D, Dewbury K , et al. The clinical importance of ultrasound detectable forefoot bursae in rheumatoid arthritis. Rheumatology (Oxford) 2010; 49 (1) 191-192
  • 15 Studler U, Mengiardi B, Bode B , et al. Fibrosis and adventitious bursae in plantar fat pad of forefoot: MR imaging findings in asymptomatic volunteers and MR imaging-histologic comparison. Radiology 2008; 246 (3) 863-870
  • 16 Girish G, Glazebrook KN, Jacobson JA. Advanced imaging in gout. AJR Am J Roentgenol 2013; 201 (3) 515-525
  • 17 Mallinson PI, Reagan AC, Coupal T, Munk PL, Ouellette H, Nicolaou S. The distribution of urate deposition within the extremities in gout: a review of 148 dual-energy CT cases. Skeletal Radiol 2014; 43 (3) 277-281
  • 18 Thiele RG, Schlesinger N. Diagnosis of gout by ultrasound. Rheumatology (Oxford) 2007; 46 (7) 1116-1121
  • 19 Chowalloor PV, Keen HI. A systematic review of ultrasonography in gout and asymptomatic hyperuricaemia. Ann Rheum Dis 2013; 72 (5) 638-645
  • 20 Glazebrook KN, Guimarães LS, Murthy NS , et al. Identification of intraarticular and periarticular uric acid crystals with dual-energy CT: initial evaluation. Radiology 2011; 261 (2) 516-524
  • 21 Ogdie A, Taylor WJ, Weatherall M , et al. Imaging modalities for the classification of gout: systematic literature review and meta-analysis. Ann Rheum Dis 2015; 74 (10) 1868-1874
  • 22 Sivera F, Andrès M, Falzon L, van der Heijde DM, Carmona L. Diagnostic value of clinical, laboratory, and imaging findings in patients with a clinical suspicion of gout: a systematic literature review. J Rheumatol Suppl 2014; 92: 3-8
  • 23 Sun Y, Ma L, Zhou Y , et al. Features of urate deposition in patients with gouty arthritis of the foot using dual-energy computed tomography. Int J Rheum Dis 2015; 18 (5) 560-567
  • 24 Gruber M, Bodner G, Rath E, Supp G, Weber M, Schueller-Weidekamm C. Dual-energy computed tomography compared with ultrasound in the diagnosis of gout. Rheumatology (Oxford) 2014; 53 (1) 173-179
  • 25 Murphey MD, Ruble CM, Tyszko SM, Zbojniewicz AM, Potter BK, Miettinen M. From the archives of the AFIP: musculoskeletal fibromatoses: radiologic-pathologic correlation. Radiographics 2009; 29 (7) 2143-2173
  • 26 Griffith JF, Wong TY, Wong SM, Wong MW, Metreweli C. Sonography of plantar fibromatosis. AJR Am J Roentgenol 2002; 179 (5) 1167-1172
  • 27 Wang Y, Tang J, Luo Y. The value of sonography in diagnosing giant cell tumors of the tendon sheath. J Ultrasound Med 2007; 26 (10) 1333-1340
  • 28 Middleton WD, Patel V, Teefey SA, Boyer MI. Giant cell tumors of the tendon sheath: analysis of sonographic findings. AJR Am J Roentgenol 2004; 183 (2) 337-339
  • 29 Quinn TJ, Jacobson JA, Craig JG, van Holsbeeck MT. Sonography of Morton's neuromas. AJR Am J Roentgenol 2000; 174 (6) 1723-1728
  • 30 Addante JB, Peicott PS, Wong KY, Brooks DL. Interdigital neuromas. Results of surgical excision of 152 neuromas. J Am Podiatr Med Assoc 1986; 76 (9) 493-495
  • 31 Bartolomei FJ, Wertheimer SJ. Intermetatarsal neuromas: distribution and etiologic factors. J Foot Surg 1983; 22 (4) 279-282
  • 32 Bennett GL, Graham CE, Mauldin DM. Morton's interdigital neuroma: a comprehensive treatment protocol. Foot Ankle Int 1995; 16 (12) 760-763
  • 33 Friscia DA, Strom DE, Parr JW, Saltzman CL, Johnson KA. Surgical treatment for primary interdigital neuroma. Orthopedics 1991; 14 (6) 669-672
  • 34 Lee MJ, Kim S, Huh YM , et al. Morton neuroma: evaluated with ultrasonography and MR imaging. Korean J Radiol 2007; 8 (2) 148-155
  • 35 Park HJ, Kim SS, Rho MH, Hong HP, Lee SY. Sonographic appearances of Morton's neuroma: differences from other interdigital soft tissue masses. Ultrasound Med Biol 2011; 37 (8) 1204-1209
  • 36 Torriani M, Kattapuram SV. Technical innovation. Dynamic sonography of the forefoot: the sonographic Mulder sign. AJR Am J Roentgenol 2003; 180 (4) 1121-1123
  • 37 Zanetti M, Weishaupt D. MR imaging of the forefoot: Morton neuroma and differential diagnoses. Semin Musculoskelet Radiol 2005; 9 (3) 175-186
  • 38 Bignotti B, Signori A, Sormani MP, Molfetta L, Martinoli C, Tagliafico A. Ultrasound versus magnetic resonance imaging for Morton neuroma: systematic review and meta-analysis. Eur Radiol 2015; 25 (8) 2254-2262
  • 39 Umans H, Srinivasan R, Elsinger E, Wilde GE. MRI of lesser metatarsophalangeal joint plantar plate tears and associated adjacent interspace lesions. Skeletal Radiol 2014; 43 (10) 1361-1368
  • 40 Wadhwa V, Lee PP, Strome GM, Suh KJ, Carrino JA, Chhabra A. Spectrum of superficial nerve-related tumor and tumor-like lesions: MRI features. Acta Radiol 2014; 55 (3) 345-358
  • 41 Abreu E, Aubert S, Wavreille G, Gheno R, Canella C, Cotten A. Peripheral tumor and tumor-like neurogenic lesions. Eur J Radiol 2013; 82 (1) 38-50
  • 42 Ryu JA, Lee SH, Cha EY, Kim TY, Kim SM, Shin MJ. Sonographic differentiation between schwannomas and neurofibromas in the musculoskeletal system. J Ultrasound Med 2015; 34 (12) 2253-2260
  • 43 Reynolds Jr DL, Jacobson JA, Inampudi P, Jamadar DA, Ebrahim FS, Hayes CW. Sonographic characteristics of peripheral nerve sheath tumors. AJR Am J Roentgenol 2004; 182 (3) 741-744
  • 44 Kransdorf MJ. Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location. AJR Am J Roentgenol 1995; 164 (1) 129-134
  • 45 Calleja M, Dimigen M, Saifuddin A. MRI of superficial soft tissue masses: analysis of features useful in distinguishing between benign and malignant lesions. Skeletal Radiol 2012; 41 (12) 1517-1524
  • 46 Friedman MV, Kyriakos M, Matava MJ, McDonald DJ, Jennings JW, Wessell DE. Intra-articular synovial sarcoma. Skeletal Radiol 2013; 42 (6) 859-867
  • 47 Bermejo A, De Bustamante TD, Martinez A, Carrera R, Zabía E, Manjón P. MR imaging in the evaluation of cystic-appearing soft-tissue masses of the extremities. Radiographics 2013; 33 (3) 833-855
  • 48 Libson E, Bloom RA, Husband JE, Stoker DJ. Metastatic tumours of bones of the hand and foot. A comparative review and report of 43 additional cases. Skeletal Radiol 1987; 16 (5) 387-392
  • 49 Maheshwari AV, Chiappetta G, Kugler CD, Pitcher Jr JD, Temple HT. Metastatic skeletal disease of the foot: case reports and literature review. Foot Ankle Int 2008; 29 (7) 699-710
  • 50 Stomeo D, Tulli A, Ziranu A, Perisano C, Maccauro VdeS. Acrometastasis: a literature review. Eur Rev Med Pharmacol Sci 2015; 19 (15) 2906-2915