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CC: 12yo boy presents with pain to base of 5th metatarsal
Osteochondrosis overuse syndromes associated with development of secondary ossification or apophyseal centers
Iselin disease – Osteochondrosis of 5th MT base
Lateral 5th foot pain with weight bearing and activity in early adolescence
Child may limp or walk on inner part of foot
Adolescents: Girls >10, Boys >12
Commonly seen in soccer, basketball, gymnastics and dance
Exam: Tenderness to palpation at proximal 5th MT at peroneal brevis insertion
Area may show edema and redness
Pain with foot inversion and resisted eversion and dorsiflexion
XR: May be normal or show enlargement or fragmentation of epiphysis
Obliquely oriented small bony fleck at 5th MT base. Parallel to long axis of 5th MT. Best seen on oblique view. Unlike fractures which tend to be horizontally oriented.
Treatment: Immobilize for comfort if severe (walking boot) or simple activity modification if mild. Ice and calf muscle stretching.
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