II. Epidemiology
- Boys are affected at a younger age than girls
III. Pathophysiology
- Traction injury of peroneus brevis insertion at base of fifth Metatarsal
- Repeat microtrauma to peroneus brevis insertion
IV. Signs
- Fifth Metatarsal base pain, swelling, tenderness
- Provocative maneuvers
- Resisted Eversion
- Passive Inversion
- Plantar Flexion
V. Imaging
-
Bedside Ultrasound or XRay
- Fragmentation and widening of the apophysis (or normal)
- MRI
- Indicated to evaluate for alternative diagnosis (e.g. Stress Fracture suspected)
VI. Differential Diagnosis
-
Fifth Metatarsal Fracture
- Acute inversion injury with avulsion Fracture
- Os Vesalianum (normal accessory bone)
- Smooth rounded bone edges (contrast with irregular edges of Apophysitis)
VII. Management
- Relative rest
- Hard-soled shoe (indicated if pain is severe)
VIII. References
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Related Studies
Concepts | Disease or Syndrome (T047) |
SnomedCT | 203395009, 77827005 |
English | Iselin's dis.(fifth metatars.), juvenile osteochondrosis of fifth metatarsal (diagnosis), juvenile osteochondrosis of fifth metatarsal, Iselin disease, Juvenile osteochondrosis of fifth metatarsal, Iselin's disease, Iselin's disease - osteochondrosis of fifth metatarsal, Iselin's disease (disorder), Juvenile osteochondrosis of fifth metatarsal (disorder), iselin's; osteochondrosis, iselin's, osteochondrosis; iselin's, Osteochondrosis of fifth metatarsal, Osteochondrosis of Iselin |
Dutch | Iselin; osteochondrose, osteochondrose; Iselin |
Spanish | enfermedad de Iselin, osteocondritis del quinto metatarsiano (trastorno), osteocondritis del quinto metatarsiano, osteocondrosis juvenil del quinto hueso metatarsiano (trastorno), osteocondrosis juvenil del quinto hueso metatarsiano |