+Calcaneal fracture, always track your cortical lines for disruptions
Dedicated calcaneus film, consider this in pt’s w/ falls or significant heel injuries concerning for a fracture. Mild hyperlucency noted (red arrow, likely calcific Achille’s tendon insertion) and hypolucency (blue arrow) concerning for a subtle fracture.
Stress Fx/Jones Fx (distal to the insertion of the peroneus brevis and 4th MT groove) Tx: Strict NWB ortho shoe 4-6wks vs possible ORIF (high risk of non-union, usually only indicated for displaced fx)
LisFranc Fracture: Mechanism is twisting on a planted foot, falls, severe plantar flexion. Fracture through the proximal MTs or midfoot disruption causes classic “Terry Thomas” sign highlighted here. Isolated fracture type.
(left) Lis Franc w/ marked MT disruption and homolateral (all 5 MTs) shift
Homolateral fracture type highly associated with cuboid fractures