Presentation
Gradually developing forefoot pain over time.
Patient Data
stress fracture at the proximal portion of the second metatarsal associated with callus formation and soft tissue edema
abnormal morphology, irregularity and cystic/stress changes at medial sesamoid bone of great toe
mild edema and stress changes at the proximal portions of second and third metatarsal bones as well as middle cuneiform bone
plantar soft tissue fibrosis/edema at the level of the first and fifth metatarsal heads suggestive of callus formation versus mild adventitial bursitis
two small Morton’s neuromas at second and third intermetatarsal spaces
Case Discussion
MRI is the most sensitive tool for detecting early features of stress fracture including periosteal edema and marrow edema. A hypointense linear fracture line, periosteal and endosteal new bone formation are the late-stage features.
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