Step-off sign
Last revised by Andrew Murphy on 1 Feb 2020
Citation, DOI, disclosures and article data
Citation:
Deng F, Murphy A, Bell D, Step-off sign. Reference article, Radiopaedia.org (Accessed on 23 May 2024) https://doi.org/10.53347/rID-73991
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rID:
73991
Article created:
31 Jan 2020,
Francis Deng ◉
Disclosures:
At the time the article was created Francis Deng had no recorded disclosures.
View Francis Deng's current disclosures
Last revised:
1 Feb 2020,
Andrew Murphy ◉
Disclosures:
At the time the article was last revised Andrew Murphy had no recorded disclosures.
View Andrew Murphy's current disclosures
Revisions:
3 times, by
3 contributors -
see full revision history and disclosures
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Synonyms:
- Stepoff sign
- Dorsal step-off sign
- Step off sign
The step-off sign is the radiographic appearance of Lisfranc injury on lateral projections of the foot when there is a dorsal displacement of the second metatarsal base. At the tarsometatarsal joint level, this displacement interrupts an imaginary line drawn on the dorsal surface of the foot 1-6. The sign is accentuated with plantar flexion and axial loading 2.
References
- 1. Gupta RT, Wadhwa RP, Learch TJ, Herwick SM. Lisfranc injury: imaging findings for this important but often-missed diagnosis. (2008) Current problems in diagnostic radiology. 37 (3): 115-26. doi:10.1067/j.cpradiol.2007.08.012 - Pubmed
- 2. Kalia V, Fishman EK, Carrino JA, Fayad LM. Epidemiology, imaging, and treatment of Lisfranc fracture-dislocations revisited. (2012) Skeletal radiology. 41 (2): 129-36. doi:10.1007/s00256-011-1131-5 - Pubmed
- 3. Burroughs KE, Reimer CD, Fields KB. Lisfranc injury of the foot: a commonly missed diagnosis. (1998) American family physician. 58 (1): 118-24. Pubmed
- 4. Punwar S, Madhav R. Subtle Lisfranc complex injury: When not to trust normal X-rays. (2007) Injury Extra. 38:250-4. doi:10.1016/j.injury.2006.10.018
- 5. Welck M, Zinchenko R, Tudor F. A painful foot: Lisfranc fracture-dislocations. (2016) BMJ (Clinical research ed.). 352: i882. doi:10.1136/bmj.i882 - Pubmed
- 6. Sivakumar BS, An VVG, Oitment C, Myerson M. Subtle Lisfranc Injuries: A Topical Review and Modification of the Classification System. (2018) Orthopedics. 41 (2): e168-e175. doi:10.3928/01477447-20180213-07 - Pubmed
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