Thursday, March 21, 2013

March Fracture

A runner increases her activity significantly after joining the college track team. A few weeks into her routine, she starts complaining of intermittent forefoot pain that occurs only with running, jumping, and dancing. The pain worsens until it occurs constantly with weight-bearing. On exam, you note point tenderness and swelling. When you hold the toe in line with the foot without angulation, pushing the toe into the metatarsal produces pain.

The first X-ray (A) is taken at this visit. The second X-ray (B) is taken 4 weeks later. The third X-ray (C) is taken 3 months later.

Challenge: What's your diagnosis?

Image shown under Fair Use.


Alex said...

insufficency stress fx

Craig Chen said...

March Fracture

First described in 1855, metatarsal stress fractures were called “march fractures” because they commonly occurred in military recruits. The first X-ray shows mild narrowing of the medullary canal of the second metatarsal; the second X-ray shows callus formation; the third X-ray shows well organized callus.

Source: UpToDate.