March fracture

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Painful midfoot for 7 months.

Patient Data

Age: 35 years
Gender: Male
mri

Abnormal bone narrow signal depicted low on T1 and high on PD fs sequences involving the third metatarsal base and proximal diaphysis associated with the surrounding soft tissue edematous changes indicating of bone marrow edema as a result of the stress fracture.

x-ray

The radiograph was negative for fracture of the third metatarsal bone.

Case Discussion

In the cases of march fracture, the plain radiographs have poor sensitivity (15-35%) in early-stage injuries, which increases in late-stage injuries (30-70%). MRI is the modality of choice with a sensitivity reported to reach close to 100% 1.

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