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First intercuneiform joint

The first intercuneiform joint is a small plane synovial joint located between the medial (first) cuneiform and the intermediate (second) cuneiform bones of the midfoot. It forms part of the intercuneiform joint complex and contributes to the stability and coordinated motion of the medial column of the foot.

It is an important anatomical landmark in foot biomechanics, midfoot imaging, trauma assessment, and surgical planning.

Synonyms

  • Medial–intermediate intercuneiform joint

  • Cuneiform I–II joint

Location

  • Situated in the midfoot

  • Between the medial (first) and intermediate (second) cuneiform bones

  • Medial to the second intercuneiform joint

  • Posterior to the first tarsometatarsal joint

  • Anterior to the naviculocuneiform joint

Anatomical components

  • Articular surfaces:

    • Lateral surface of the medial cuneiform

    • Medial surface of the intermediate cuneiform

  • Joint type:

    • Plane synovial joint

  • Joint capsule:

    • Thin fibrous capsule enclosing the joint

  • Supporting ligaments:

    • Dorsal intercuneiform ligament

    • Plantar intercuneiform ligament

    • Interosseous intercuneiform ligament

Relations

Anteriorly:

  • Bases of the first and second metatarsals

Posteriorly:

  • Navicular bone

Medially:

  • Medial cuneiform bone

Laterally:

  • Intermediate cuneiform bone

Superiorly:

  • Dorsal midfoot soft tissues and extensor tendons

Inferiorly:

  • Plantar ligaments and intrinsic foot muscles

X-ray appearance

Plain radiographs (AP, oblique, and lateral foot views):

  • Joint line: Thin radiolucent line between medial and intermediate cuneiforms

  • Alignment: Smooth articular margins without step-off

  • Best visualized on: AP and oblique views

  • Relationship: Seen as part of the medial intercuneiform articulation

CT appearance

Non-contrast CT:

  • Joint space: Narrow, well-defined plane between the two cuneiforms

  • Articular surfaces: Smooth cortical margins

  • Spatial detail: Excellent depiction of joint congruity and subtle irregularities

  • Orientation: Obliquely aligned joint plane within the midfoot

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal

  • Cuneiform marrow: High signal intensity

  • Joint space: Thin low-signal line between the bones

T2-weighted images:

  • Articular cartilage: Intermediate-to-high signal

  • Joint fluid (if present): High signal outlining the joint

  • Adjacent bone cortex: Low signal

STIR:

  • Fat suppression: Uniform suppression of marrow fat

  • Joint margins: Clearly delineated

  • Ligamentous structures: Seen as low-signal bands

Proton density fat-saturated (PD FS):

  • Joint space: Well visualized with high contrast

  • Cartilage surfaces: Intermediate signal

  • Supporting ligaments: Low-signal linear structures

CT VRT 3D image

First intercuneiform joint

MRI image

First intercuneiform joint joint mri anatomy labelled image-img-00000-00000

X Ray image

First intercuneiform joint