Basic forefoot protocol used for the imaging of suspected pathology distal to the naviculocuneiform joint. This protocol does not attempt to include the ankle and is orientated to the plane of the metatarsals and the pitch axis of the forefoot.

Useful to assess:

• Arthropathies of the midfoot, TMT, MTP and interphalangeal joints of the toes
• Plantar plate injury
• Morton’s neuroma
• Tendon and ligament injury
• Diabetic ulceration and osteomyelitis (see adaptations)
• Soft tissue masses

Single digit sequences should be utilised for high resolution tendon imaging

Positioning

Forefoot well padded and centred in foot & ankle coil.

Scan

• High resolution foot & ankle coil
• Base FOV 120mm ± 1mm
• Orthogonal planes based on axis of metatarsals

Sequence	Slice / Gap
T1 Long axis	2.5mm / 0.3mm
PDFS Long axis	2.5mm / 0.3mm
T2FS transverse	3mm / 0.3mm
PDFS sagittal	2.5mm / 0.3mm

Variants

Suspected infection or mass lesion

Replace PDFS and T2FS with STIR

Coping with metalwork

• Increase slice thickness and gap
• High bandwith STIR or PDFS (MARS/SEMAC)

Single digit or high resolution tendon series

• Reduce FOV and coverage to crop to single digit (range MTPJ to penultimate IPJ)
• Increase spatial resolution of non-SSFP sequences

Sequence	Slice / Gap
T1 Long axis	2.5mm / 0.3mm
PDFS Long axis	2.5mm / 0.3mm
T2FS transverse	3mm / 0.3mm
VIBE Sagittal	0.3mm isotropic