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Annular Pulley Rupture of the Toes: Expanding the Differential Diagnosis for Forefoot Pain with Novel MR Findings

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Case: Herein is presented a case of rupture of the A2/A3 annular pulleys of the left second toe in a 33-year-old male patient after a snowboarding injury. The injury was… Click to show full abstract

Case: Herein is presented a case of rupture of the A2/A3 annular pulleys of the left second toe in a 33-year-old male patient after a snowboarding injury. The injury was detected on magnetic resonance imaging (MRI) 7 weeks after the initial trauma. The patient was treated conservatively, including toe splinting, with the patient returning to his asymptomatic preinjury baseline after 6 months. Conclusion: Annular pulley rupture of the toes is a novel cause of prolonged forefoot pain. Clinician awareness of this unique injury and its often subtle MRI findings may help avoid delays in appropriate diagnosis and treatment.

Keywords: annular pulley; pulley rupture; rupture toes; rupture; forefoot pain

Journal Title: JBJS Case Connector
Year Published: 2022

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