Lisfranc Injury Symptoms and Diagnosis
The key sign of a Lisfranc injury is bruising or blistering on the arch or top of the foot.
Lisfranc injury symptoms
Other symptoms of a Lisfranc injury may include:
- Swelling of the foot, especially on the top
- Pain in the midfoot that worsens when standing/walking or when pressure is applied
- Abnormal widening of the foot
- Inability to bear weight/walk without an aid, such as crutches (in severe injuries)
Lisfranc injury diagnosis
Lisfranc injuries are known for being easily misdiagnosed. They often present as ankle sprains or other foot/ankle injuries. This makes the diagnosis especially important for these injuries.
To arrive at a diagnosis, both physical examinations and imaging tests are necessary. The sports medicine physician or surgeon will ask questions about how the injury occurred and will examine the foot to determine the severity of the injury. X-rays and other imaging studies can assist in fully evaluating the extent of the injury. The physician or surgeon may also perform an additional examination while the patient is under anesthesia to further evaluate a fracture or weakening of the joint and surrounding bones.
The physical examination may include exercises like standing on the tiptoes of the injured foot or holding the toes and moving them up and down. Standing on the tiptoes puts significant stress on the midfoot, and the patient should notice pain from even a slight Lisfranc injury. Meanwhile, moving the toes up and down puts pressure on the midfoot, which will also produce pain if there in an injury there.
Imaging for a Lisfranc injury may include X-rays to show any broken bones and the alignment of the Lisfranc joint complex. If it is out of alignment, it may suggest that there is injury to the ligaments in that area of the foot. X-rays of the undamaged foot may help for comparison. In some cases, CT scans or MRIs will also be used. These tests provide more detailed imaging of the foot than X-rays and allow doctors to view soft tissues.