@Marlena Jbara Love the insight re: repairing plantar plate tears without addressing the cause

@Im Beg Agreed, thanks for sharing!

I concur Disclaimer: Only looked at the stills

Based on the still images and clinical history, agree with traction periostitis from tibialis anterior This RadSource article has a nice discussion of differential. They talk about how differentials, including chronic exertional compartment syndrome (CECS) and bony stress injuries, can all coexist. One technique they describe for CECS is to perform imaging before and after exercise and to look for increased muscle size and edema after exercise As for other etiologies, the author adds muscle strain, DVT, muscle hernia, etc. DVT is an interesting consideration given the ancillary findings in your case: "However, unlike compartment syndrome, deep venous thrombosis causes venous occlusion and commonly results in subcutaneous edema and skin thickening, which are all findings that can be displayed with MR imaging" https://radsource.us/compartment_syndrome_leg/

Very difficult case, looking forward to the follow-up MRI. Thanks Professor Hermann for the explanation