Topics

Topic

design image
Second tarsometatarsal joint

The second tarsometatarsal joint (2nd TMT joint) is the articulation between the base of the second metatarsal and the intermediate (second) cuneiform bone. It is the central and most stable joint of the tarsometatarsal (Lisfranc) complex and plays a key role in maintaining the transverse and longitudinal arches of the foot.

It is a critical anatomical landmark in foot biomechanics, Lisfranc joint stability, trauma assessment, and midfoot imaging.

Synonyms

  • Second TMT joint

  • Second Lisfranc joint component

Location

  • Situated in the midfoot

  • Between the base of the second metatarsal and the intermediate cuneiform

  • Central within the tarsometatarsal joint line

  • Between the first and third tarsometatarsal joints

  • Inferior to the distal row of tarsal bones

Anatomical components

  • Articulating bones:

    • Base of the second metatarsal

    • Intermediate (second) cuneiform

  • Joint type:

    • Synovial plane joint

  • Joint capsule and ligaments:

    • Dorsal tarsometatarsal ligaments

    • Plantar tarsometatarsal ligaments

    • Interosseous Lisfranc ligament (closely related, between medial cuneiform and second metatarsal base)

  • Articular cartilage lining both joint surfaces

Relations

Anteriorly:

  • Shaft of the second metatarsal

Posteriorly:

  • Intermediate cuneiform

Medially:

  • First tarsometatarsal joint and medial cuneiform

Laterally:

  • Third tarsometatarsal joint and lateral cuneiform

Superiorly:

  • Dorsal foot soft tissues and extensor tendons

Inferiorly:

  • Plantar ligaments and plantar fascia

X-ray appearance

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

  • Joint space: Thin radiolucent line between second metatarsal base and intermediate cuneiform

  • Alignment: Base of the second metatarsal aligns with the intermediate cuneiform

  • Cortical margins: Smooth and symmetric

  • Best visualized on: AP and oblique views

CT appearance

Non-contrast CT:

  • Joint surfaces: Clearly defined cortical margins

  • Articular congruity: Accurate depiction of joint alignment

  • Subchondral bone: Normal trabecular pattern

  • Joint space: Uniform and well visualized

  • Utility: Excellent for assessing subtle osseous details and joint morphology

MRI appearance

T1-weighted images:

  • Bone marrow: High signal in metatarsal base and cuneiform

  • Cortical bone: Low signal outlining joint surfaces

  • Joint space: Low-to-intermediate signal

T2-weighted images:

  • Articular cartilage: Intermediate signal

  • Joint fluid: High signal outlining the joint

  • Ligaments: Low-signal linear bands

STIR:

  • Fat suppression: Uniform marrow fat suppression

  • Joint space: Clearly delineated by bright fluid signal

  • Surrounding soft tissues: Well visualized

Proton density fat-saturated (PD FS):

  • Bone marrow: Fat suppressed

  • Joint fluid: High signal

  • Capsule and ligaments: Sharply outlined as low-signal structures

MRI image

Second tarsometatarsal joints mri anatomy labelled image-img-00000-00000

CT VRT 3D image

Second tarsometatarsal joints 3d