Stress fracture of metatarsal

Case contributed by Yusra Sheikh
Diagnosis certain

Presentation

3 week history of pain in the forefoot over the second metatarsal. No history of trauma.

Patient Data

Age: 13 years
Gender: Male
x-ray

There is a focal area of periosteal new bone formation on medial aspect of second metatarsal shaft with a subtle sclerotic line traversing the shaft (most appreciable on oblique view), most suggestive of a healing stress fracture.

Case Discussion

Subsequent follow up imaging demonstrated interval healing of the fracture. Differentials to be considered with such radiographic appearances in the clinical setting of no trauma are osteomyelitis and bone malignancy such as osteosarcoma.

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