Stress fracture of 4th metatarsal

Case contributed by Dr Matt Skalski

Presentation

Soccer player with onset of foot pain 1 week prior to this study. Pain is worse with weight bearing.

Patient Data

Gender: Male
Modality: X-ray

There is a linear transverse lucency with surrounding sclerosis approximately 2cm distal to the base of the 4th metatarsal, with extension of this line through the cortex and thin callus formation. There is also a contour irregularity near the base of the 5th metatarsal with increased osseous density in this region and a faint lucent region within the sclerotic area.  

Case Discussion

The findings are consistent with an acute stress fracture of the 4th metatarsal, and a subacute or old stress fracture of the base of the 5th metatarsal.

This is often referred to as a march fracture, given its tendency to occur following repeat low level trauma, such as soldiers who march (as part of drill training) for long concentrated periods.

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Case Information

rID: 23932
Case created: 18th Jul 2013
Last edited: 26th Feb 2016
Inclusion in quiz mode: Included

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