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Cuneocuboid interosseous ligament

The cuneocuboid interosseous ligament is a short, strong fibrous band connecting the lateral cuneiform to the medial surface of the cuboid bone. It forms part of the deep intertarsal ligamentous network that reinforces the midtarsal region of the foot, contributing to stability between the tarsal bones.

This ligament lies deep within the midfoot, beneath the dorsal and plantar ligaments, and is not visible externally. It provides strong interosseous support, preventing separation or abnormal motion between the cuboid and lateral cuneiform during weight-bearing or torsional stresses.

Injury to this ligament is rare but may occur with severe midfoot trauma, Lisfranc injuries, or rotational forces that disrupt the tarsal arch. It is an important structure to recognize on imaging when evaluating midfoot instability.

Synonyms

  • Interosseous ligament between lateral cuneiform and cuboid

  • Cuneocuboid intertarsal ligament

  • Lateral cuneiform–cuboid interosseous band

Origin, Course, and Insertion

  • Origin: Deep surface of the lateral cuneiform, near its posterior aspect

  • Course: Short, thick, and obliquely oriented band running laterally and slightly posteriorly between the adjacent non-articular roughened areas of the two bones

  • Insertion: Medial surface of the cuboid bone, near its base

Relations

  • Superiorly: Dorsal cuneocuboid ligament and extensor tendons

  • Inferiorly: Plantar cuneocuboid ligament and plantar aponeurosis

  • Medially: Lateral cuneiform bone and intermediate cuneiform

  • Laterally: Cuboid bone and peroneus longus tendon (in its groove on plantar cuboid)

  • Posteriorly: Calcaneocuboid joint capsule

  • Anteriorly: Cuneocuboid joint cavity

Function

  • Stabilization: Provides firm connection between lateral cuneiform and cuboid, reinforcing the midtarsal joint complex

  • Load transfer: Transmits mechanical forces between the medial and lateral columns of the foot

  • Arch support: Contributes to the stability of the transverse and longitudinal arches

  • Motion restriction: Limits abnormal gliding or rotational movements between cuneiform and cuboid during stance and gait

Arterial Supply

  • Supplied primarily by branches of the dorsalis pedis artery and lateral tarsal artery, with minor contributions from the perforating peroneal artery.

Clinical Significance

  • Injury: May be injured in severe midfoot sprains, fractures, or Lisfranc fracture–dislocations involving the cuneiform-cuboid region.

  • Degeneration: Chronic strain or repetitive torsional stress can lead to fibrotic thickening or partial tearing.

  • Surgical relevance: Important stabilizer identified in reconstructive midfoot or arthrodesis procedures.

  • Imaging role: Assessed in cases of midfoot instability, coalition, or arthropathy. Its integrity is crucial for maintaining tarsal alignment.

MRI Appearance

  • T1-weighted images:

    • Normal ligament appears as a thin, low-signal (dark) band connecting the lateral cuneiform and cuboid.

    • Adjacent bone marrow and fat appear bright, providing contrast.

    • Partial tears or degeneration may show intermediate signal within the ligament substance.

  • T2-weighted images:

    • Normal ligament: low signal intensity, darker than on T1.

    • Tears or sprains: focal or diffuse hyperintense signal with loss of ligament definition.

    • Surrounding edema or joint effusion: bright hyperintense areas adjacent to ligament.

  • STIR:

    • Normal ligament remains dark.

    • Pathology: hyperintense signal in ligament and adjacent bone indicating edema or acute strain.

  • Proton Density Fat-Saturated (PD FS):

    • Normal ligament: dark continuous band with sharp margins.

    • Partial tear: bright focal signal within the ligament fibers.

    • Complete tear: discontinuity and fluid-filled gap between bones.

  • T1 Fat-Sat Post-Contrast:

    • Normal ligament: minimal or no enhancement.

    • Inflamed or injured ligament: contrast enhancement due to vascular granulation tissue.

    • Chronic scarring: irregular or heterogeneous enhancement.

CT Appearance

Non-Contrast CT:

  • Ligament not directly visualized; appears as a thin soft-tissue density between lateral cuneiform and cuboid.

  • Helpful for identifying bony avulsion fragments or irregularities at attachment sites.

  • Chronic changes may show subchondral sclerosis or osteophyte formation at the cuneocuboid joint.

Post-Contrast CT (standard):

  • Limited role; used mainly to assess adjacent soft-tissue inflammation or postoperative scarring.

  • The ligament itself remains poorly defined, but surrounding fat stranding or enhancement suggests injury.

MRI image

Cuneocuboid interosseous ligament axial cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

MRI image

Cuneocuboid interosseous ligament coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000