Monday, July 20, 2015

Dasher, Prancer, Vixen

Sorry about the disorganized cases; I've been traveling in Europe, and internet hasn't been as quick as easy as I hoped.

A basketball player comes in complaining of foot pain that occurred when he landed awkwardly after a jump. A runner has the same complaint when she inverts her ankle running on an uneven surface. Both are worried they sprained their ankle. Their pain is on the lateral edge of their foot. There is focal tenderness, bruising, and swelling at the base of the fifth toe. Both can walk but it's quite painful to do so.

Here is a radiograph:

Challenge: What's the diagnosis?

Image shown under Fair Use.


RaH said...

this is a Jones V fracture of the fifth metatarsal after a supination (eversion) trauma.
it is one of the typical fractures after a supination trauma. other fractures include weber fractures of type a,b,c and maisonneuve.
before doing an X ray in this type of trauma the ottawa ankle rules or bernes ankle rules should be applied...
the cause of the fracture is the insertion of the M. fibularis/peronneus brevis. which tears of the tuberositas when the muscle is streched forcefully.

keep up the nice cases... i enjoy them!

Craig Chen said...

yep - always important to know the ottawa ankle rules
Dasher, Prancer, Vixen

This is a fifth metatarsal tuberosity (styloid) avulsion fracture, sometimes called a dancer’s fracture. It occurs due to forced inversion of the foot and ankle while in plantarflexion.

Source: UpToDate.