Avulsion fracture of the dorsal cuboid bone

Case contributed by Mohammad A. ElBeialy
Diagnosis certain


Lateral foot pain. Trauma since 1 year. Diagnosed with tendinopathy and pain since then. Initial radiographs were reported as unremarkable and MRI was requested.

Patient Data

Age: 35 years
Gender: Female

Marrow edema signal is seen at the dorsal surface of the postero-lateral cuboid bone.

Avulsion fracture of the dorsal surface of the postero-lateral cuboid bone is seen.

Annotated image

Red arrows point at the detached crescent-shaped bone fragments at dorsal surface of the postero-lateral cuboid bone. 

Case Discussion

Isolated cuboid fracture is a rare fracture. Fracture cuboid is uncommon (about 5 to 10 percent of the tarsal fractures) and is frequently associated with lateral column fracture or tarsometatarsal joint fracture-dislocation. So, full examination of the foot for other fractures is a must. Routine radiographs must include oblique medial view.

Avulsion fractures are the most common of the tarsal fractures representing about 70% of the cuboid fractures. Other cuboid fractures are stress fracture, body fracture, or fracture-dislocation of the cuboid.

Avulsion fractures of the cuboid mostly occur at the insertion of the plantar calcaneocuboid ligament. Others may be along the lateral border of the cuboid due to cuboid adduction on the calcaneus, posing tension on the lateral calcaneocuboid ligament.  

Body fractures of the cuboid are usually intra-articular and crescentic-shaped and due to rotational motion trauma to the forefoot in a plantar-flexed position. The most common mechanism causing a body fracture is a nutcracker fracture and is commonly associated with a navicular fracture.

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