Clarius Classroom

1st Metatarso-phalangeal (MTP)

Dr. Oron Frenkel, MD

Diagnose classic gouty arthropathy by identifying fluid in the 1st metatarsophalangeal space, and enable arthrocentesis or injection under direct ultrasound guidance.

Specialties: MSK
Applications: MSK
this is a scan using a linear transducer at a shallow precept of the first metatarsal phalangeal joint here we have the head of the metatarsal and here's the proximal phalanx this is going to represent the joint space and continues with that joint we see this hypoechoic fluid collection suggesting a joint diffusion when we put on power doppler we can see that it is quite hyperemic suggesting an inflammatory process here these findings represent given the anatomic location most likely gouty arthropathy but other diagnoses should be entertained including a potential septic joint or other causes of an inflammatory arthritis

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