Presentation
Foot pain after soccer match 2 days prior. Unable to weight bear. No foot swelling or bruising. Minor tenderness over the first metatarsophalangeal joint on examination.
Patient Data
PA view demonstrated mild soft tissue swelling over the first metatarsophalangeal joint. No acute fracture. Bipartite tibial sesamoid (abductor hallucis tendon sesamoid) bone incidentally noted. Oblique view showed acute transverse fracture through tibial sesamoid bone (abductor hallucis tendon sesamoid) which was interpreted as a bipartite sesamoid bone on AP view.
Case Discussion
Bipartite sesamoid bones are commonly seen normal variant.
In our case, additional view demonstrated acute fracture of tibial sesamoid (abductor hallucis tendon sesamoid) which was initially misinterpreted as bipartite sesamoid.
It is important to have at least two views provided for correct interpretation of plain radiographs so that the pathology mimicking normal variant could not be missed.
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