Thursday, November 12, 2015


A 35 year old marathon runner comes to you because of foot pain. The pain is mostly in the medial arch of her foot. There is point tenderness over a bony prominence inferior and anterior to the medial malleolus. Imaging is shown above.

Challenge: What's your diagnosis?

Image shown under Fair Use.


RaH said...

seems like a Taesal Navicular Fracture... (avulsion fracture.)
this here presents like a stress fracture due to the race and training. it can be cause by the continious tear of the M. tibialis posterior or due to ligaments (lig deltoides ) on the tuberosity of the navicular bone

a different idea would be a tendinitis of the M tibialis posterior... but this wouldnt have a clear fracture on the X ray
a different way to break the navicular bone is with exeessive axial load...especially when running on hard surfaces

there is quite a risk for non union and avascular necrosis (AVN)

its nice to see some more ortho.. i am currently in anesthesia...

Craig Chen said...

great discussion!

This is a navicular stress fracture.

Source: UpToDate.