{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:40:57Z","timestamp":1760060457194,"version":"build-2065373602"},"reference-count":66,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Plantar plate injuries represent a common yet frequently underdiagnosed etiology of forefoot pain and metatarsophalangeal joint instability. Diagnostic accuracy is often compromised by nonspecific clinical presentations and significant symptom overlap with other forefoot pathologies, including Morton\u2019s neuroma and synovitis. Early and accurate identification is essential to prevent progression to irreversible deformity. Methods: This narrative review synthesizes recent literature on the clinical evaluation, imaging modalities, and differential diagnosis of plantar plate injuries. A comprehensive literature search in a narrative review format of key databases and relevant journals was performed to critically appraise the diagnostic accuracy, advantages, limitations, and clinical implications of various diagnostic techniques. Results: Physical examination maneuvers\u2014including the drawer test, toe purchase test, and Kelikian push-up test\u2014provide important diagnostic insights but are constrained by operator dependency and lack of standardization. Among imaging modalities, MRI and dynamic ultrasound offer high diagnostic utility, with MRI providing superior specificity and ultrasound enabling functional, real-time assessment. Emerging techniques such as dorsiflexion-stress MRI and dual-energy CT show promising diagnostic potential, though broader clinical validation is lacking. Differential diagnosis remains a major challenge, given the clinical and radiological similarities shared with other forefoot conditions. Conclusions: Accurate diagnosis of plantar plate injuries necessitates a multimodal strategy that combines clinical suspicion, structured physical examination, and advanced imaging. Acknowledging the limitations of each diagnostic modality and integrating findings within the broader clinical context are essential for timely and accurate diagnosis. Future research should prioritize validation of diagnostic criteria, enhanced access to dynamic imaging, and the development of consensus-based grading systems to improve diagnostic precision and patient outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics15172188","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:08:52Z","timestamp":1756458532000},"page":"2188","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosing Plantar Plate Injuries: A Narrative Review of Clinical and Imaging Approaches"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3421-339X","authenticated-orcid":false,"given":"Jeong-Jin","family":"Park","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Korea Armed Forces Athletic Corps, Mungyeong 36931, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7244-2698","authenticated-orcid":false,"given":"Hyun-Gyu","family":"Seok","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Armed Forces Capital Hospital, Seongnam 13574, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3101-8655","authenticated-orcid":false,"given":"Chul Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"641","DOI":"10.2214\/ajr.163.3.8079860","article-title":"Plantar plate of the foot: Findings on conventional arthrography and MR imaging","volume":"163","author":"Yao","year":"1994","journal-title":"AJR Am. 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