Iselin disease is a benign and self-limiting condition, defined as apophysitis of the base of the 5th metatarsal.
It is most commonly seen in males with sport injuries and is often also seen in adolescents.
It is due to repetitive traction of the peroneus brevis tendon at the site of its attachment. Predisposing factors are jumping and running.
- obliquely oriented small bony fleck at the base of the 5th metatarsal which is best seen on oblique radiograph
- apophyseal irregularity
Usually not considered essential for the diagnosis. But if performed may show:
- T2/STIR: high signal intensity around base of 5th metatarsal due to bone marrow edema 6
History and etymology
First described by Hans Iselin (1878-1953) 8 a German surgeon working in Basel, Switzerland, in 1912 4,5.
On imaging consider:
- 1. Strayer SM, Reece SG, Petrizzi MJ. Fractures of the proximal fifth metatarsal. Am Fam Physician. 1999;59 (9): 2516-22. Pubmed citation
- 2. Birrer RB, Griesemer B, Cataletto MB. Pediatric Sports Medicine for Primary Care. Lippincott Williams & Wilkins. (2002) ISBN:0781731593. Read it at Google Books - Find it at Amazon
- 3. Porter DA, Schon LC. Baxter's the foot and ankle in sport. Mosby. ISBN:0323023584. Read it at Google Books - Find it at Amazon
- 4. Iselin H. Wachstumbeschwerden zer zeit der knockern entwicklung metatarsi quinti. Deut Z Chir 1912;117:529
- 5. Forrester RA, Eyre-Brook AI, Mannan K. Iselin's Disease: A Systematic Review. (2017) The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. 56 (5): 1065-1069. doi:10.1053/j.jfas.2017.04.030 - Pubmed
- 6. Kishan TV, Mekala A, Bonala N, Sri Pavani B. Iselin's disease: Traction apophysitis of the fifth metatarsal base, a rare cause of lateral foot pain. (2016) Medical journal, Armed Forces India. 72 (3): 299-301. doi:10.1016/j.mjafi.2015.06.015 - Pubmed
- 7. Deniz G, Kose O, Guneri B, Duygun F. Traction apophysitis of the fifth metatarsal base in a child: Iselin's disease. (2014) BMJ case reports. doi:10.1136/bcr-2014-204687 - Pubmed
- 8. William F. Bynum, Vivian Nutton. Essays in the History of Therapeutics. (1991) ISBN: 9789051832662