Magnetic resonance imaging (MRI) is a powerful tool in the diagnosis of missed or occult fractures on radiographic and computed tomography (CT) imaging, through the detection of bone marrow edema. While radiologists often rely on bone marrow edema as a guide for diagnosing subtle underlying fractures, it is important to recognize its limitations as a diagnostic metric. We present a rare case demonstrating the absence of bone marrow edema after acute trauma and confirmed Lisfranc fracture in a patient with preeclampsia and propose an interesting physiologic mechanism to explain this manifestation.

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