Iselin Disease

Aka: Iselin Disease, Iselin's Disease, Fifth Metatarsal Apophysitis

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II. Epidemiology

  1. Boys are affected at a younger age than girls

III. Pathophysiology

  1. Traction injury of peroneus brevis insertion at base of fifth Metatarsal
    1. Repeat microtrauma to peroneus brevis insertion

IV. Signs

  1. Fifth Metatarsal base pain, swelling, tenderness
  2. Provocative maneuvers
    1. Resisted Eversion
    2. Passive Inversion
    3. Plantar Flexion

V. Imaging

  1. Bedside Ultrasound or XRay
    1. Fragmentation and widening of the apophysis (or normal)
  2. MRI
    1. Indicated to evaluate for alternative diagnosis (e.g. Stress Fracture suspected)

VI. Differential Diagnosis

  1. Fifth Metatarsal Fracture
    1. Acute inversion injury with avulsion Fracture
  2. Os Vesalianum (normal accessory bone)
    1. Smooth rounded bone edges (contrast with irregular edges of Apophysitis)

VII. Management

  1. Relative rest
  2. Hard-soled shoe (indicated if pain is severe)

VIII. References

  1. Achar (2019) Am Fam Physician 99(10): 610-8 [PubMed]

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Related Studies

Ontology: Iselin's disease (C0264100)

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
Derived from the NIH UMLS (Unified Medical Language System)

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