Citation, DOI, disclosures and article data
Citation:
Venkatesh M, Elfeky M, Silverstone L, et al. Iselin disease. Reference article, Radiopaedia.org (Accessed on 27 Mar 2025) https://doi.org/10.53347/rID-25356
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.
The exact etiology is not known although accepted by many as occurring due to repetitive traction of the peroneus brevis tendon at the site of its attachment.
It can be more frequently seen in children engaged in sporting activities which require running and jumping.
Plain radiograph
- obliquely oriented small bony fleck at the base of the 5th metatarsal which is best seen on oblique radiograph
- apophyseal irregularity
MRI
Usually not considered essential for the diagnosis. But if performed may show:
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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.
Imaging differential considerations include
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1. Strayer S, Reece S, Petrizzi M. Fractures of the Proximal Fifth Metatarsal. Am Fam Physician. 1999;59(9):2516-22. - Pubmed
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2. Richard B. Birrer, Bernard Griesemer, Mary B. Cataletto. Pediatric Sports Medicine for Primary Care. (2002) ISBN: 9780781731591 - Google Books
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3. David A. Porter, Lew Schon. Baxter's the Foot and Ankle in Sport. (2008) ISBN: 9780323023580 - Google Books
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4. Iselin H. Wachstumbeschwerden zer zeit der knockern entwicklung metatarsi quinti. Deut Z Chir 1912;117:529
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5. Forrester R, Eyre-Brook A, Mannan K. Iselin's Disease: A Systematic Review. J Foot Ankle Surg. 2017;56(5):1065-9. doi:10.1053/j.jfas.2017.04.030 - Pubmed
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6. Kishan T, Mekala A, Bonala N, Sri Pavani B. Iselin's Disease: Traction Apophysitis of the Fifth Metatarsal Base, a Rare Cause of Lateral Foot Pain. Med J Armed Forces India. 2016;72(3):299-301. doi:10.1016/j.mjafi.2015.06.015 - Pubmed
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7. Deniz G, Kose O, Guneri B, Duygun F. Traction Apophysitis of the Fifth Metatarsal Base in a Child: Iselin's Disease. BMJ Case Rep. 2014;2014(may14 4):bcr2014204687. doi:10.1136/bcr-2014-204687 - Pubmed
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8. William F. Bynum, Vivian Nutton. Essays in the History of Therapeutics. (1991) ISBN: 9789051832662 - Google Books
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9. Sylvester J & Hennrikus W. Treatment Outcomes of Adolescents with Iselin's Apophysitis. J Pediatr Orthop B. 2015;24(4):362-5. doi:10.1097/BPB.0000000000000157 - Pubmed
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