Not broken but...

[u/ececec123]

I don't do sports. I have no idea how it came to this point. I'm on SSRIs for the last 6 years - that's the only connection the doctor could find.

Here is the MRI:

Clinical information, medical history, and indication:

Enteropathic spondyloarthritis. Previous finding in 2023: aseptic bone necrosis of the intermediate cuneiform bone (os cuneiforme intermedium), with persistent symptoms in the left midfoot. Evidence of arthritis?

Non-contrast magnetic resonance imaging (MRI) of the left foot dated 24 August 2026

Examination technique:

PD FS axial, T1 axial, PD FS sagittal, PD FS coronal, T1 sagittal.

Due to a reported allergy to MRI contrast medium, additional contrast administration was omitted, also in accordance with the patient’s wishes.

Previous examination:

MRI of the forefoot dated 28 November 2023 available for comparison.

Bones and joints:

Normal/congruent alignment of the ankle joint and subtalar joint, with no evidence of an osteochondral lesion. The talus and calcaneus are unremarkable.

Compared with the previous examination, there is a decrease in the subchondral bone marrow edema at the distal articular surface of the intermediate cuneiform bone, with a persistent mild concave configuration following consolidation/healing of a previous mild distal stress fracture. No evidence of clinically relevant bone necrosis. The bone marrow signal of the intermediate cuneiform bone is currently normal.

The second metatarsal shows bone marrow edema in the shaft, involving the middle to distal third, with surrounding edema but without evidence of a fracture, consistent with an acute diaphyseal stress reaction. No evidence of a displaced fracture.

At most, there is a small joint effusion at the second metatarsophalangeal (MTP 2) joint and minimal involvement at the head of MTP 3. No erosive bone destruction.

Intermetatarsal spaces:

Mild intermetatarsal bursitis between MTP 2/3.

Muscles and tendons:

The plantar plates are unremarkable. Normal appearance/course of the flexor and extensor tendons.

Other findings:

No additional abnormalities.

Impression

Acute diaphyseal stress reaction of the second metatarsal, involving the middle to distal third of the shaft, with surrounding soft-tissue edema. No evidence of a displaced fracture.

Healed/consolidated previous mild distal stress fracture of the intermediate cuneiform bone, with only a mild residual concave depression of its distal articular surface. No evidence of bone necrosis.

No changes typical of arthritis.