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?

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2 comments:

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.