Presentation
An older lady presents with unexplained foot pain.
Patient Data
Age: 65 years
Gender: Female
From the case:
Stress fracture of third metatarsal
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false},"extraPropsURL":"/studies/23848/annotated_viewer_json?lang=us"}
At first glance the x ray is unremarkable. Closer inspection shows the most subtle of periosteal reactions distal 3rd metatarsal on the right.
From the case:
Stress fracture of third metatarsal
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false},"extraPropsURL":"/studies/29594/annotated_viewer_json?lang=us"}
Arrow indicates area of the most subtle of periosteal reactions distal 3rd metatarsal on the right.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false},"extraPropsURL":"/studies/23849/annotated_viewer_json?lang=us"}
12 weeks later the fracture shows solid osseous union with residual sclerosis.
Case Discussion
Look very carefully for the faintest of periosteal reactions if a stress fracture is supected.