MSK imaging: Lisfranc injury: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · MSK imaging: Lisfranc injury

Sample item

After a twisting injury to the midfoot, a weight-bearing radiograph shows a gap between the bases of the first and second metatarsals and a small avulsed fragment (fleck sign). What is the injury?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Lisfranc fracture-dislocation

The Lisfranc ligament binds the medial cuneiform to the second metatarsal base, and its disruption widens the first-second interval and may avulse a small fleck. It is often missed and leads to midfoot arthritis if untreated.

Option by option

  • A. Jones fracture

    A Jones fracture is at the proximal fifth metatarsal.

  • B. Lisfranc fracture-dislocation (correct)

    Correct. Widened first-second metatarsal base gap with a fleck sign is a Lisfranc injury.

  • C. Calcaneal fracture

    A calcaneal fracture changes the Bohler angle.

  • D. Achilles tendon rupture

    Achilles rupture is a tendon injury seen on ultrasound.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Lisfranc fracture-dislocation. The Lisfranc ligament binds the medial cuneiform to the second metatarsal base, and its disruption widens the first-second interval and may avulse a small fleck.

Why is "Jones fracture" not the answer?

A Jones fracture is at the proximal fifth metatarsal.

Why is "Calcaneal fracture" not the answer?

A calcaneal fracture changes the Bohler angle.

Why is "Achilles tendon rupture" not the answer?

Achilles rupture is a tendon injury seen on ultrasound.

What concept does this question test?

It tests MSK imaging: Lisfranc injury in Radiology. It is often missed and leads to midfoot arthritis if untreated.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study MSK imaging: Lisfranc injury?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.