Presentation
Pain and tenderness of the left midfoot for six weeks.
Patient Data
Age: 15 years
Gender: Male
From the case:
Stress fracture
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Focal periosteal reaction of the medial > lateral aspect of the proximal third metatarsal
consistent with a stress fracture.
Case Discussion
In this patient with no known/visible bone disease, this is a fatigue type of stress fracture. That is, it is due to stress disproportionate to what the bone is used to which is otherwise normal bone (cf. insufficiency type of stress fractures).
Fatigue fractures of the metatarsals are common and historically were often called march fractures due to their association with soldiers who developed them after repetitive marching.