There is swelling, bruising, and point tenderness at the dorsolateral aspect of the foot. Is Clostridium difficile Gram-positive or negative? How long will it take to heal? The principle behind the surgical intervention for cuboid fractures is to maintain the length of the lateral column and restore the congruency of the articular surfaces. On physical exam he is tender over the midfoot, but has full strength with dorsiflexion, plantarflexion and inversion. Cuboid fractures are frequently associated with other fractures, dislocations, or ligament injuries and may result in considerable long-term disability. (2016) The Bone & Joint Journal. It is located at the outer aspect of the mid foot just in front of the ankle (figure 1). (OBQ12.256) What is the difference between c-chart and u-chart? It might take up to 12 weeks for you to fully heal. Zoomed view oblique X-ray shows chip fracture at the right cuboid bone, clearly seen at the oblique view. Most often, those with orthopedic walking boots or casts will need to wear them for six to eight weeks. Avulsion fractures are typically treated by: resting the affected area. A cuboid impaction fracture, also referred to as a nutcracker fracture, is an uncommon fracture of the cuboid bone on the outside of the foot (Figure 1). Avulsion fractures of the calcaneal tuberosity are uncommon, . 562 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with mcc; 563 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc; 963 Other multiple significant trauma . They were classified into five patterns of injury. . An 18-year-old gymnast has had a 1-year history of foot pain. It is important to seek medical help immediately. After receiving a proper diagnosis, this syndrome is easily fixed. The doctors decided to put my foot in a plaster cast and put me on crutches for 14 days. At what age does the calcaneus ossify? Surgical management is indicated for . 2 doctor answers 7 doctors weighed in. Other cuboid fractures are stress fracture, body fracture, or fracture-dislocation of the cuboid. Surgical management is indicated for nonunions, significantly displaced fractures, and for elite athletes. Due to joint-line tenderness, severe pain with weight bearing, and lack of findings consistent with his mechanism of injury, the patient was referred to an orthopaedic physician with a recommendation for imaging of the foot. Inversion and Eversion Injuries Ankle sprains are the most common type of trauma affecting the inferior limb. As the injury worsens, symptoms gradually progress to pain at rest, which is a cardinal symptom of a stress fracture. X-ray shows chip fracture at the right cuboid bone, clearly seen at the oblique view. Management should consist of which of the following? Cortisone injection in to the anterior tibial tendon sheath, Non-weightbearing in a cast for planned 6-8 weeks, Open reduction internal fixation of the fracture. b : a sudden cutting off of land by flood, currents, or change in course of a body of water especially : one separating land from one persons property and joining it to anothers. Treatment is generally nonoperative with cast immobilization and non weight-bearing for the majority of fractures. What is the optimal treatment for this condition? Recovery time from an avulsion fracture can range from several weeks to several months, depending on the severity of the injury, the location of the injury, and how promptly . What is the most common complication associated with the injury seen in Figure A? Diagnosis can be made with plain radiographs of the foot. Do this for 30 minutes at a time, as often as you can. Avulsion fractures of the cuboid mostly occur at the insertion of the plantar calcaneocuboid ligament. This is the American ICD-10-CM version of S92.21 - other international versions of ICD-10 S92.21 may differ. Isolated avulsion fractures are, as a rule, not associated with any deformity. Clinical presentation There is swelling, bruising, and point tenderness at the dorsolateral aspect of the foot. In cuboid fractures with minimal pain and swelling, treating with an elastic bandage or with a fracture boot and walking with partial weight bearing until the satisfactory regression of the symptoms, may be enough. On examination: mild swelling, hotness, and tenderness over the lateral malleolus and base of the dorsal side of the right foot. Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Avulsion fractures are the most common of the tarsal fractures representing about 70% of the cuboid fractures. An avulsion fracture is where a fragment of bone is pulled away at the ligamentous or tendinous attachment. Swelling and ecchymosis over the cuboid should raise suspicion of this injury and when other midfoot injuries are present , the cuboid articulations should be carefully inspected for subtle injury. Other cuboid fractures are stress fracture, body fracture, or fracture-dislocation of the cuboid. Cuboid fractures rarely occur in isolation, and a high index of suspicion for the presence of Chopart, Lisfranc, or complex midfoot injuries should be raised. 84A fractures are the most common cuboid fracture. Hold the walker with one hand and the handrail with the other. Type 2 fractures (25 fractures, 13%) are isolated extra-articular injuries involving the body of the cuboid. Avulsion fractures of the cuboid mostly occur at the insertion of the plantar calcaneocuboid ligament. The treatment of this fracture is simple, immobilization by a splint. The cuboid is a wedge shaped bone, being widest at its medial edge and narrow at its lateral edge. An axial CT scan of the midfoot is shown in Figure 20. Physical therapy can play an essential role in promoting full recovery from the effects of cuboid syndrome. 2 : a mass or particle of ossified tissue. Thank. Closed fracture of left cuboid; Left cuboid (foot bone) fracture; ICD-10-CM S92.212A is grouped within Diagnostic Related Group(s) (MS-DRG v 40.0):. A 27-year-old man reported to a physical therapist via direct access with severe left lateral midfoot pain during weight bearing. Hard-sole shoe and partial weight bearing, Short leg cast and partial-weight bearing. Oblique. Researchers speculate that solid AFOs and walking boots negatively affect balance by limiting ankle joint motion, which decreases proprioceptive feedback from ankle joint receptors and muscle spindles around the ankle joint while also limiting the ankle strategy for correcting postural alignment. {"url":"/signup-modal-props.json?lang=us\u0026email="}, ElBeialy M, Avulsion fracture of the dorsal cuboid bone. Have been wearing a soft cast (moon boot) for the past three days. b : the hardening (as of muscular tissue) into a bony substance. If you dont get medical attention, your broken bone might take longer to heal or it might not heal in the right way. When avulsion fracture is identified, a high suspicion index is needed to exclude Lisfranc and Chopart injuries. Copyright 2022 Lineage Medical, Inc. All rights reserved. Sometimes the area will be bruised. Results: Type 1 fractures (93 fractures, 48.4%) are simple avulsion injuries involving the capsule of the calcaneo-cuboid joint. Pain and swelling at the right ankle and foot since this morning after a twisted ankle while step down the stairs. If descending the stairs, follow the same instructions, but step down with the injured leg. A 21-year-old recreational baseball player presents for evaluation of anterior ankle pain that has been persistent for the past 6-8 weeks. Avulsion fractures of the cuboid mostly occur at the insertion of the plantar calcaneocuboid ligament. Cuboid subluxation, often called Cuboid Syndrome, is discussed separately History "Nutcracker" fracture first described by Hermel and Gershon-Cohen in 1953 [1] Epidemiology Rare fracture pattern, poorly described in the literature Midfoot are rare and have an annual incidence of approximately 3.6/100,000 fractures [2] The ligament or tendon also may be damaged. a : a tearing away of a body part accidentally or surgically. Fractures usually take about three to 12 weeks to heal completely. Avulsion fractures usually happen to young athletes. The skin, toes, or fingers of your injured limb become swollen, cold, or blue. Summary. Which type of chromosome region is identified by C-banding technique? His radiographs are read as normal; radiographs are shown in Figure A. Publication types Review : a forcible separation or detachment: such as. Depends on fracture: A small avulsion fracture of the cuboid may require no treatment other than crutches and pain control. Unable to process the form. A 24-year-old female who is training for her first marathon presents with six weeks of increasing foot pain. Dec 416, 2022, Revised proximal femur module is now online. Cuboid stress fractures are fractures of the inside of the cuboid that occur most often in athletes. (SBQ12FA.26) People with this fracture are more likely to develop problems healing that require an operation. Read More. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. If the original injury was small, most people begin to feel relief within a few days. The cuboid helps provide for the stability of the foot and the movement of the toes, in addition to ensuring proper weight distribution and flexibility along the plantar fascia that runs along the sole of the foot. These fractures are low-energy injuries due to twisting the foot with inversion of the hindfoot and adduction of the forefoot. A fracture is a break or crack in a bone that often results from an injury. Most avulsion fractures will heal without surgery, but if the chunk of bone is too far away from the main bone, you may need surgery. Other cuboid fractures are stress fracture, body fracture, or fracture-dislocation of the cuboid. Most of the time, however, avulsion fractures do not require surgery. This will help reduce pain and swelling. What do the C cells of the thyroid secrete? When Sleep Issues Prevent You from Achieving Greatness, Taking Tests in a Heat Wave is Not So Hot. . Avulsion fracture of the dorsal surface of the postero-lateral cuboid bone is seen. Particularly in high-energy trauma (eg, motor vehicle collision), cuboid fractures may occur in association with several additional tarsal fractures, and complex articular dislocations [ 3 ]. With an avulsion fracture, an injury to the bone occurs near where the bone attaches to a tendon or ligament. The injury usually occurs secondary to the traumatic abduction of the forefoot. mechanism is plantarflexion or eversion/inversion, can involve talonavicular or naviculocuneiform ligaments, mechanism is eversion with simultaneous contraction of PTT, may represent an acute widening/diastasis of an accessory navicular, mechanism of injury is usually due to chronic overuse, often seen in athletes running on hard surfaces, most common complications include delayed union and non-union, Spontaneous navicular AVN (Mueller-Weiss syndrome), Spontaenous navicular AVN is a rare disease that and can be seen in middle aged adults with chronic midfoot pain, navicular bone and its articulations play an important role in inversion and eversion biomechanics and motion, Sangeorzan Classification of Navicular Body Fractures, (based on plane of fracture and degree of comminution). When. As the majority of these injuries are simple extraarticular fractures, surgical treatment is rarely required. (OBQ06.61) Lateral foot pain. On examination: mild swelling, hotness, and tenderness over the lateral malleolus and base of the dorsal side of the right foot. Orthopedic Surgery 23 years experience. Transverse fracture of dorsal fragment that involves < 50% of bone. A cuboid stress fracture is a condition characterized by an incomplete crack in the cuboid bone. An avulsion fracture occurs when an injury causes a ligament or tendon to break off (avulse) a small piece of a bone thats attached to it. Cuboid fractures have the potential to cause considerable deformity involving the foot arch, lateral column, and the function of the forefoot. You might be sprinting, hitting, sliding or doing other sports activities that involve quick movements and sudden changes in direction. It can be caused by traumatic traction (repetitive long-term or a single high impact traumatic traction) of the ligament or tendon. What does the term ossification mean? Adding a sock to the equation is a good idea for a few reasons: It will help reduce any friction between the brace and your skin, which can help prevent any chafing or blisters. Cuboid fractures are frequently associated with other fractures, dislocations, or ligament injuries and may result in considerable long-term disability. A piece of bone attached to a ligament or tendon breaks away from the main part of the bone. usually full ROM of ankle and subtalar joint, may be difficult to see and are often missed, more sensitive to identify fracture than radiographs, will show signal intensity on T2 image due to inflammation, any navicular stress fracture, regardless of type, can be initially treated with cast immobilization and nonweight bearing for 6-8 weeks with high rates of success, failure of cast immobilization and non weight bearing, minimally displaced Type I and II navicular body fractures, avulsion fractures that failed to improve with nonoperative modalities, tuberosity fractures that went on to symptomatic nonunion, avulsion fractures involving > 25% of articular surface, tuberosity fractures with > 5mm diastasis or large intra-articular fragment, displaced or intra-articular Type I and II navicular body fractures, used for Type I and II navicular body fractures, ORIF followed by external fixation vs. primary fusion, fusion of talonavicular and naviculocuneiform joints in navicular avascular necrosis. 1a : the natural process of bone formation. Wearing compression sock and brace in a shoe. Diagnosis can be made with plain radiographs of the foot. Codes within the T section that include the external cause do . Check for errors and try again. Frontal. Pain can worsen with standing or walking, and can make walking on the foot impossible. Avulsion fractures are the most common of the tarsal fractures representing about 70% of the cuboid fractures. It really hurt me when I put any weight on my foot and I limped quite badly. Place the two front legs of the walker on the first step. Calcaneal fracture rep-resents 60% offractures of the tarsal bones. Oftentimes, a podiatrist can efficiently relocate the bone, which is followed by only minor aching. An avulsion fracture occurs when a bone fragment is pulled away from its main bone by soft tissue such as ligaments or tendons attached to it. It often starts quite suddenly and lasts throughout the day. Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-91886. Connect with peers, learn from experts. Most avulsion fractures heal very well without surgical intervention. Related Radiopaedia articles The patient will most often be unwilling to walk and put weight on the lateral aspect of the foot. Marrow edema signal is seen at the dorsal surface of the postero-lateral cuboid bone. Avulsion fractures of the cuboid mostly occurs at the insertion of the plantar calcaneo-cuboid ligament. Fracture cuboid is uncommon (about 5 to 10 percent of the tarsal fractures) and is frequently associated with lateral column fracture or tarsometatarsal joint fracture-dislocation. Representative MRI sequences are shown Figures B and C. What is the most appropriate treatment for this patient? Inversion is the leading injury mechanism and consist in adduction, plantar-flexion and supination of the foot resulting in stressful forces on ankle-lateral-collateral-ligaments, possibly with distraction, avulsion or even rupture of anterior talofibular and calcaneofibular-ligaments. Weight bearing as tolerated in a hard soled shoe, Fragment excision and posterior tibial tendon advancement, Open reduction with autologous bone graft, 2023 Bobby Menges Memorial HSS Limb Reconstruction Course, Type in at least one full word to see suggestions list. Avulsion fractures of the cuboid are classified by the AO/OTA as 84A fractures. While each case is different, in most cases you do NOT have to wear a CAM walker while your sleeping. Walking: You may walk on the foot as comfort allows but you may find it easier to walk on your heel in the early stages. talus: 7 months in utero. 3.3k views Reviewed >2 years ago. You may feel a pop and sudden pain when the fracture occurs. I am a Pod in the UK and have had serious lateral foot pain for around 10 years. ADVERTISEMENT: Supporters see fewer/no ads. I have seen a Pod surgeon and also and ortho surgeon and the decision was made that they weren't sure what was wrong so exploratory surgery . Initially, the pain is only with weight-bearing and activity. Primary ossification centres present at birth calcaneus: 6 months in utero. This injury may be part of a Lisfranc or Chopart injury, in which case there may also be bruising at the plantar aspect and medial pain. Posterior Tibial Tendon Insufficiency (PTTI). This is an AAOS Self Assessment Exam (SAE) question. I have a checkup on Monday and I was looking forward to it because I . The most common mechanism causing a body fracture is a nutcracker fracture and is commonly associated with a navicular fracture. Presentation Pain and swelling at the right ankle and foot since this morning after a twisted ankle while step down the stairs. The cuboid is the anatomical name given to one of the bones in the mid foot. It still hurts and I can't walk normal. If supplied, wear the boot for comfort when walking. An avulsion fracture of the ankle can take between three and 12 weeks to heal. Avulsion fractures of the cuboid mostly occur at the insertion of the plantar calcaneocuboid ligament. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Yonso M, Avulsion fracture of the cuboid. This fracture gets worse with time if you keep walking on it, so non-weight bearing is very important. This occurs as tendons can bear more load than the bone. Tarsal Navicular Fractures are rare fractures of the midfoot that may occur due to trauma or due to repetitive microstress. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Supporting your weight evenly between the handrail and walker, step up with your good leg. (SBQ07SM.35) (SAE07SM.72) x_ray. Patient Data Age: 45 years Gender: Male x_ray Frontal Oblique X-ray Frontal A member asked: I have a cuboid (possibly an avulsion) fracture in my right foot. You DO have to put the boot back on before you put your feet down in the morning. Fenton P., Al-Nammari S., Blundell C., Davies M.. Treatment of an avulsion fracture typically includes resting and icing the affected area, followed by controlled exercises that help restore range of motion, improve muscle strength and promote bone healing. What is the shape of C Indologenes bacteria? What are the differences between a male and a hermaphrodite C. elegans? Particularly in high-energy trauma (eg, motor vehicle collision), cuboid fractures may occur in association with several additional tarsal fractures, and complex articular dislocations [ 3 ]. If you have been given a boot to wear, it is for your comfort only and is not needed to aid fracture healing. 3 : a tendency toward or state of . Its anterior surface is separated into two facets by a vertical ridge, allowing articulation of the base of the fourth and fifth metatarsal. The 2023 edition of ICD-10-CM S92.21 became effective on October 1, 2022. Patients will generally present with insidious onset of pain over weeks to months. Type 2 Cuboid Fracture A stable isolated extra-articular fracture. Case Discussion. osseous fragment greater than 5 mm and angulation greater than 10; and type 4, compression fracture of medial cuboid and major joint distraction. Most avulsion fractures arent medical emergencies, but they are still a serious medical condition. There are 5 main classifications of cuboid fractures that we have outlined below: Type 1 Cuboid Fracture An avulsion fracture is where a tendon or ligament pulls off a fragment of bone. From the case: Avulsion fracture of the cuboid. Routine radiographs must include oblique medial view. Cuboid syndrome causes sharp pain on the outer side, and possibly underside, of the foot. Examination reveals medial midfoot tenderness without swelling. Others may be along the lateral border of the cuboid due to cuboid adduction on the calcaneus, posing tension on the lateral calcaneocuboid ligament. Abstract. It has three main articular surfaces: anterior, medial and posterior. Avulsion fractures can occur in any area where soft tissue is attached to bone. A nutcracker fracture of the cuboid refers to a cuboid bone fracture with associated navicular avulsion fracture due to compression between the bases of 4 th and 5 th metatarsals and calcaneus bone. The most common mechanism asso-ciated with this type of injury is inversion of . Figure 1 - Relevant Anatomy for a Cuboid Stress Fracture Avulsion fractures are the most common of the tarsal fractures representing about 70% of the cuboid fractures. cuboid by an interosseous ligament. Avulsion fractures of the cuboid are classified by the AO/OTA as 84A fractures. If your child has an avulsion fracture that involves a growth plate, they may need surgery as well. Dr. Rahul Banerjee answered. Out of boot at 6 weeks. No further imaging is required. 1. See a healthcare provider if you have pain, swelling, numbness, or difficulty moving a limb. Calcaneus Fractures - Trauma - Orthobullets orthoBULLETS MBBULLETSStep 1For 1st and 2nd Year Med Students MBBULLETSStep 2 & 3For 3rd and 4th Year Med Students ORTHOBULLETSOrthopaedic Surgeons & Providers JOIN NOWLOGIN Home Topics Techniques Cards QBank Evidence Cases Videos Podcasts Groups Products Trauma Spine Shoulder & Elbow Knee & Sports Partial weight bearing in a walking cast for an additional 6 weeks, Open reduction and internal fixation with autologous bone grafting, Non-weight-bearing in a cast for an additional 6 weeks. Fractures of the cuboid can present with varying swelling and deformity of the lateral midfoot. X-ray. This occurs because the inside of the bone will fatigue and develop a small crack. The treatment of this fracture is simple, immobilization by a splint. Body fractures of the cuboid are usually intra-articular and crescentic-shaped and due to rotational motion trauma to the forefoot in a plantar-flexed position. Just a quick question, I sprained my ankle last week and the diagnosis was a slight cuboid avulsion fracture. The original injury occurred doing athletics and since then I have been unable to sprint or generally run without pain. Socks for walker boots can act as a buffer between your foot (and its sweat and dead skin cells) and the brace. The pain in your injured limb gets worse even after you rest and take medicine. ADVERTISEMENT: Supporters see fewer/no ads. In the case of severe initial pain, a short walking cast for 4-6 wk is recommended[30]. The patient will most often be unwilling to walk and put weight on the lateral aspect of the foot. Non-weight-bearing in a cast for 6 weeks has failed to provide relief. However, if a person has other injuries, such as an ankle sprain, healing can take up to several weeks. Red arrows point at the detached crescent-shaped bone fragments at dorsal surface of the postero-lateral cuboid bone. One way doctors diagnose cuboid syndrome is by moving the foot inwards and outwards to see exactly where the pain is stemming from. The purpose of this study is to describe the clinical and radiographic presentation of cuboid fractures in children and to produce a guide for appropriate evaluation and treatment.Twenty-eight consecutive patients with cuboid fracture treated at the same institution between 1998 and 2004 were retrospectively analyzed. X-ray shows chip fracture at the right cuboid bone, clearly seen at the oblique view. Treatment is generally nonoperative with cast immobilization and non weight-bearing for the majority of fractures. An AP radiograph and representative axial cut of her CT scan of her injury are seen in figures A and B. Thank you. Cuboid avulsion fracture A 31-year-old member asked: What is the treatment for cuboid avulsion fracture ? Other cuboid fractures are stress fracture, body fracture or fracturedislocation of the cuboid. This type of injury can happen in the hip, ankle, knee, heel, elbow, or pelvis. Bandage your wound: Bandages keep your wound clean, dry, and protected from infection. From the case: Avulsion fracture of the cuboid. This does not need surgery Type 3 Cuboid Fracture Is it healthier to drink herbal tea hot or cold? Elevate your wound: Prop your injured area on pillows to raise it above the level of your heart. Nonoperative management is reserved for nondisplaced articular fractures (<1 mm) or avulsion fractures that are caused by low-energy trauma. Approximate Synonyms. In this study, 67% of patients treated with a CAM walker boot for at least 2 weeks reported new or worsened secondary site pain at the time of transition out of the boot. Diagnosed with tendinopathy and pain since then. Most fractures heal without any problems in about six weeks. Radiographs revealed an avulsion fracture . This imag shows a dorsal avulsion fracture of the cuboid. You can rate this topic again in 12 months. He is found on imaging to have a navicular stress fracture. You will probably have some pain and swelling in the area of the fracture. Avulsion fractures are the most common of the tarsal fractures representing about 70% of the cuboid fractures. Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-51586. Unable to process the form. What is the most appropriate initial immobilization and weight-bearing status for this patient? 9 weeks after cuboid avulsion fracture. For an avulsion fracture in your pelvis or anywhere else where your healthcare provider cant apply a cast, a short period of rest followed by crutches is helpful. Others may require non weight bearing for a pro. Avulsion fracture of the dorsal cuboid bone. Non-displaced fractures such as avulsion fractures (like this case) and stress fractures are treated with conservative methods of treatment while complex injuries involving complex fractures with significant displacement and intra-articular involvement require anatomic reduction and external or internal osteosynthesis. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Isolated cuboid fracture is a rare fracture. So, full examination of the foot for other fractures is a must. Function. X-ray. Trauma since 1 year. applying ice packs. Avulsion fractures are the most common of the tarsal fractures representing about 70% of the cuboid fractures. The patterns of injury and management of cuboid fractures. cuboid: 9 months in utero. The pain does not usually spread to the rest of the foot or leg. A total of 192 fractures in 188 patients were included. This injury occurs in the setting of a forceful outward (eversion-abduction) or downward (plantarflexed) movement of the foot. A 45-year-old man presents to the orthopaedic clinic complaining of several weeks of increasing midfoot pain during and after his daily run that he recently resumed after a 2-week vacation. Check for errors and try again. Other cuboid fractures are stress fracture, Isolated anterior process fractures account for approximately 15% of all cal-caneal fractures and are often overlooked and misdiagnosed as ankle sprains [1, 2]. You might need to wear a cast or splint for a few weeks. Zoomed view oblique. X-ray. Usually, you can take the boot off once you get in bed for the night. Symptoms usually improve after the injury heals. Tarsal Navicular Fractures are rare fractures of the midfoot that may occur due to trauma or due to repetitive microstress. Frontal and oblique foot radiographs, not ankle radiographs, are most optimal for showing these fractures, which characteristically . 84A fractures are the most common cuboid fracture. No further imaging is required. Avulsion fractures are the most common of the tarsal fractures representing about 70% of the cuboid fractures. Initial radiographs were reported as unremarkable and MRI was requested. Oblique fracture, usually from dorsal-lateral to plantar-medial. X-ray. However, it may take three to six months for your symptoms to settle completely these can include pain or discomfort, stiffness, decreased strength, and swelling. Other cuboid fractures are stress fracture, body fracture, or fracture-dislocation of the cuboid. This is treated using a cast boot and crutches for 4-6 weeks. Dr. Ahmad M Hadiedanswered Orthopedic Surgery 50 years experience Talk now Very simple Cam Boot: Avulsions: common due to numerus capsular and ligamentous attachments to the cuboid. You can use Radiopaedia cases in a variety of ways to help you learn and teach. 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