Traction apophysitis base of the 5th metatarsal (Iselin disease)

Case contributed by Dr Dalia Ibrahim

Presentation

Pain and swelling along the lateral aspect of the right foot.

Patient Data

Age: 13 years
Gender: Male

Elevation and irregularity of the apophysis with overlying soft tissue swelling.

Elevation and irregularity of the apophysis with overlying soft tissue swelling.

Case Discussion

Iselin disease is a benign and self-limiting condition, defined as apophysitis of base of 5th metatarsal.

It is due to repetitive traction of peroneus brevis tendon at the site of its attachment. Predisposing factors are jumping and running.

Apophysis of the fifth metatarsal base appears on plain radiographs at age 12 for boys and 10 for girls. Fusion of the apophysis to the metatarsal base usually occurs within the following 2–4 years. 

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