Lateral Midfoot Pain in A Basketball Player: April 2020

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Lateral Midfoot Pain in a Basketball Player
Article · April 2020
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Ivan Turkalj
Clinical Center of Vojvodina
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Universal Journal of Radiology and Nuclear Medicine
Image Article Volume: 1, Issue: 1 Scientific Knowledge
Lateral Midfoot Pain in a Basketball Player

Ivan Turkalj*1, Borko Vukosav2, Aleksandar Spasic1
1
Clinical Center of Vojvodina, Novi Sad, Serbia
2
Health Center, Novi Sad, Serbia
A 17-year-old male basketball player sustained a left

foot injury during sudden change of direction and
backing on the lateral foot margin, but with no
mechanism of distortion, was referred for MRI of
the foot (Figure 1). He ceased all the training
activities due to severe pain and feel of instability in
the region of the lateral foot aspect. A month before
the injury, he had had intense trainings two times a Figure 1
day with no complaints. On admission, four weeks Answer 1. Figure 1 shows bone marrow oedema
after the injury, moderately antalgic gait with seen affecting the latero-plantar ridge of the cuboid
sparring of the left foot was seen. Mild swelling of (Figure 1A and 1B, arrow) in terms of stress reaction
the left foot in projection of the calcaneo-cuboid with associated peroneus longus tendon sheath
joint with significant palpable tenderness of the effusion seen below (Figure 1A, arrowhead) and
plantar projection of the cuboid was demonstrated. extending to the level of the 1st metatarsal
Painful and limited inversion and adduction of the attachment (Figure 1C, arrowhead) in keeping with
left foot was shown. No neurological or vascular tenosynovitis. Given findings comprise the clinical
abnormalities of the left foot were noted. entity named cuboid syndrome that is believed to be
Question 1. What abnormalities are shown in the caused by repetitive or strenuous eversion of the
Figure 1? cuboid leading to calcaneocuboid joint subluxation
Question 2. What is the mechanism of injury and [1].
which sports activities are prone the most to this kind
of injury? Corresponding author: Ivan Turkalj, Clinical Center of
Question 3. Which enthesopathy is frequently Vojvodina, Novi Sad, Serbia. E-mail:

[email protected]
associated with this type of injury?
Received Date: April 21, 2020; Accepted Date: April 23,
Question 4. What are treatment options for this 2020; Published Date: April 25, 2020
entity?
Univer J Radiol Nucl Med Volume 1(1): 2020

Answer 2. There are three recognized mechanisms Answer 4. Manual reduction is the first line
of the cuboid syndrome: lateral ankle sprain, management for this entity in terms of pushing the
overuse peroneal tendinopathy causing repetitive cuboid dorsally followed by subsequent physical
cuboid eversion, and levering of the lateral foot treatment with high intensity laser therapy and
across a protrusion in the ground while running. exercises for foot strengthening. Also, cuboid pad
Long distance runners and ballet dancers are the placement in the early recovery is advised so as to
most frequently affected, however there is a report prevent further cuboid subluxation [2]. The patient
of an 18-year-old basketball player suffered the had uneventful recovery with full ability for
same condition [2]. basketball activities four months after the treatment
Answer 3. Achilles enthesopathy is significantly commencement.
associated with the cuboid syndrome, especially in References:
patients with underlying inflammatory arthropathy. 1. Ashley DZ, Morgan C, Herman DC.
The cuboid forms a pulley for the peroneus longus Recognizing Cuboid Syndrome. Current
tendon and it is proposed that the fibrocartliage Sports Medicine Reports 2018; 17:6.
located between the tendon and bone serves as 2. Mazerolle SM. Cuboid Syndrome in a
functional enthesis which is antigenic target in College Basketball Player: A Case Report.
rheumatoid arthritis. Interestingly, these patients Athletic Therapy Today 2007; 12:9-11.
usually had no localized pain or tenderness on the 3. Chang MY, Hong SH, Yoo HJ, Choi JY,
cuboid, unless there was an associated stress fracture Chae HD, Moon SJ. MRI of Cuboid Pulley
[3]. Lesion. AJR 2018; 211:867–871.
Citation: Ivan Turkalj. Lateral Midfoot Pain in a Basketball Player. Univer J Radiol Nucl Med. 2020; 1: 1001.
Copy Right: © 2020 Ivan Turkalj. This is an open-access article distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Univer J Radiol Nucl Med Volume 1(1): 2020
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See discussions, stats, and author profiles for this publication at: https://www.researchgate.

Lateral Midfoot Pain in a Basketball Player

Article · April 2020

The user has requested enhancement of the downloaded file.

Image Article Volume: 1, Issue: 1 Scientific Knowledge

Lateral Midfoot Pain in a Basketball Player

A 17-year-old male basketball player sustained a left

Question 3. Which enthesopathy is frequently Vojvodina, Novi Sad, Serbia. E-mail:

Univer J Radiol Nucl Med Volume 1(1): 2020

Univer J Radiol Nucl Med Volume 1(1): 2020

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