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Second intercuneiform joint

The second intercuneiform joint is the articulation between the intermediate (second) cuneiform and its adjacent cuneiform bones within the midfoot. It forms part of the complex tarsal articulation that contributes to the stability and contour of the medial longitudinal and transverse arches of the foot.

It is an important anatomical component of the midfoot, particularly in relation to the Lisfranc joint complex and midfoot biomechanics.

Synonyms

  • Intercuneiform joint between medial and intermediate cuneiforms

  • Intercuneiform articulation (second)

Location

  • Situated in the midfoot

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

  • Medial to the lateral (third) cuneiform

  • Proximal to the bases of the metatarsals

  • Distal to the navicular bone

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 lined by synovium

  • Stabilizing structures:

    • Intercuneiform ligaments (dorsal, plantar, and interosseous)

Relations

Anteriorly:

  • Bases of the first and second metatarsals

Posteriorly:

  • Navicular bone

Medially:

  • Medial cuneiform

Laterally:

  • Intermediate cuneiform

Inferiorly (plantar):

  • Plantar ligaments and tendons of intrinsic foot muscles

Superiorly (dorsal):

  • Dorsal intercuneiform ligaments and extensor tendons

X-ray appearance

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

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

  • Alignment: Parallel, well-matched articular margins

  • Best seen on: AP and oblique views of the foot

  • Relation to Lisfranc joint: Lies proximal to the tarsometatarsal joints

CT appearance

Non-contrast CT:

  • Joint surfaces: Well-defined cortical margins

  • Joint space: Narrow and uniform

  • Bone texture: Normal trabecular pattern of adjacent cuneiforms

  • Spatial detail: Excellent visualization of joint orientation and congruity

MRI appearance

T1-weighted images:

  • Bone marrow of cuneiforms: High signal

  • Cortical bone: Low signal

  • Joint space: Thin low-signal cleft between bones

T2-weighted images:

  • Joint space: High-signal fluid-equivalent line

  • Articular cartilage: Intermediate signal

  • Surrounding ligaments: Low signal

STIR:

  • Fat-suppressed marrow: Uniform signal

  • Joint margins: Clearly visualized

  • Plantar and dorsal soft tissues: Bright signal due to fat suppression

Proton density fat-saturated (PD FS):

  • Joint space: High signal if fluid is present

  • Ligaments: Well delineated as low-signal bands

  • Bone–joint interface: Clearly demonstrated

CT VRT 3D image

Second intercuneiform joint

MRI image

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

X Ray image

Second intercuneiform joint