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Base of metatarsal bone

The base of the metatarsal bone forms the proximal end of each metatarsal, articulating with the tarsal bones to establish the tarsometatarsal (Lisfranc) joints. These bases play a vital role in weight transfer, arch stability, and propulsion during gait.

Each metatarsal base is expanded for strong ligamentous and tendinous attachments, allowing it to withstand compressive and torsional forces. The first metatarsal base articulates with the medial cuneiform; the second with the intermediate cuneiform; the third with the lateral cuneiform; and the fourth and fifth with the cuboid.

The fifth metatarsal base has a prominent tuberosity (styloid process) for the insertion of the fibularis brevis tendon, a common site of avulsion and stress fractures.

Synonyms

  • Proximal end of metatarsal

  • Metatarsal base

  • Lisfranc articulation

Location and Articulations

  • Location: Proximal end of the metatarsal shaft, connecting the forefoot to the midfoot

  • Articulations:

    • First: medial cuneiform

    • Second: intermediate cuneiform and occasionally lateral cuneiform

    • Third: lateral cuneiform

    • Fourth: cuboid and sometimes lateral cuneiform

    • Fifth: cuboid (and occasionally articulates with the fourth metatarsal base)

Surfaces and Features

  • Dorsal surface: Rough for dorsal tarsometatarsal ligament attachment

  • Plantar surface: Gives origin to plantar tarsometatarsal ligaments and interossei muscles

  • Lateral surface: Especially pronounced in fifth metatarsal base (styloid process)

  • Medial surface: Articulations and ligamentous connections with adjacent metatarsal bases

  • Articular facets: For cuneiforms and cuboid, varying per metatarsal number

Attachments

  • Tendons:

    • Fibularis brevis (inserts into tuberosity of fifth metatarsal)

    • Tibialis posterior (occasional slip to base of second, third, and fourth metatarsals)

    • Fibularis tertius (to dorsal surface of fifth metatarsal base)

  • Ligaments:

    • Dorsal and plantar tarsometatarsal ligaments

    • Intermetatarsal ligaments connecting adjacent metatarsal bases

Relations

  • Superiorly: Dorsal interossei muscles and dorsal venous arch

  • Inferiorly: Plantar interossei and plantar fascia

  • Medially: Adjacent metatarsal bases (except first metatarsal, which is isolated)

  • Laterally: Tendons of fibularis brevis and tertius (notably near fifth base)

  • Posteriorly: Cuneiform or cuboid articulation

  • Anteriorly: Metatarsal shafts

Arterial Supply

  • Dorsalis pedis artery (dorsal metatarsal branches)

  • Lateral and medial plantar arteries via plantar metatarsal branches

  • Perforating arteries form dorsal–plantar anastomoses around the base

Venous Drainage

  • Drains into dorsal venous arch and plantar venous plexus, converging into posterior tibial and fibular veins

Function

  • Weight transmission: Transfers forces from tarsal to metatarsal shafts during stance and propulsion

  • Arch stability: Contributes to medial and lateral longitudinal arches

  • Articular support: Forms tarsometatarsal (Lisfranc) joints for midfoot flexibility

  • Muscle leverage: Provides attachment for tendons aiding dorsiflexion, eversion, and stabilization

Clinical Significance

  • Fractures: Common in fifth metatarsal base (avulsion, Jones, or stress fractures)

  • Lisfranc injuries: Involve tarsometatarsal joint dislocation or ligament rupture

  • Accessory ossicles: Os vesalianum or os peroneum may mimic avulsion fragments

  • Degenerative changes: Osteoarthritis in chronic instability or post-traumatic states

  • Imaging relevance: MRI and CT vital for subtle stress fractures, edema, or tarsometatarsal injuries

MRI Appearance

  • T1-weighted images:

    • Normal marrow: bright signal intensity due to fatty content

    • Cortex: dark low-signal rim outlining bone

    • Fracture: linear dark line with adjacent low-signal edema

    • Bone bruise: focal low signal replacing bright marrow

    • Ligaments appear dark; adjacent tendons of fibularis brevis and tertius visible at fifth base

  • T2-weighted images:

    • Normal marrow: bright signal, depending on fat composition

    • Cortex: dark

    • Bone edema, fracture, or contusion: hyperintense signal replacing bright marrow

    • Soft tissue swelling or hematoma: bright hyperintensity adjacent to cortex

  • STIR (Short Tau Inversion Recovery):

    • Normal marrow: dark signal (fat suppressed)

    • Pathology (stress fracture, contusion, infection): bright hyperintense signal

    • Useful for early detection of stress reaction before cortical disruption

  • Proton Density Fat-Saturated (PD FS):

    • Normal marrow: dark, fat suppressed

    • Bone edema or inflammation: bright signal

    • Excellent for assessing ligamentous injuries and early bone stress

  • T1 Fat-Sat Post-Contrast:

    • Normal marrow: uniform enhancement

    • Fracture or infection: heterogeneous or rim enhancement

    • Chronic sclerosis or necrosis: minimal enhancement

CT Appearance

Non-Contrast CT:

  • Demonstrates cortical and trabecular detail precisely

  • Fractures: cortical breaks, sclerotic stress lines, or avulsion fragments

  • Fifth metatarsal base: common site of avulsion or Jones fractures

  • Degenerative changes: subchondral sclerosis, cysts, or joint space narrowing

Post-Contrast CT (standard):

  • Bone itself enhances minimally

  • Highlights adjacent soft tissue inflammation or infection

  • Useful for evaluating healing response and cortical remodeling

CT VRT 3D image

Base of metatarsal bone 3d ver image

MRI image

base of the metatarsal bone coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

CT image

base of the metatarsal bone ct image

MRI image

base of metatarsal bone coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000