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Stress fracture of third metatarsal

Case contributed by Garth Kruger
Diagnosis certain

Presentation

An older lady presents with unexplained foot pain.

Patient Data

Age: 65 years
Gender: Female

At first glance the x ray is unremarkable. Closer inspection shows the most subtle of periosteal reactions distal 3rd metatarsal on the right. 

Annotated image

Arrow indicates area of the most subtle of periosteal reactions distal 3rd metatarsal on the right. 

12 weeks later

x-ray

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.

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