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Iselin Disease
Aka: Iselin Disease, Iselin's Disease, Fifth Metatarsal Apophysitis
- See Also
- Apophysitis
- Epidemiology
- Boys are affected at a younger age than girls
- Pathophysiology
- Traction injury of peroneus brevis insertion at base of fifth Metatarsal
- Repeat microtrauma to peroneus brevis insertion
- Signs
- Fifth Metatarsal base pain, swelling, tenderness
- Provocative maneuvers
- Resisted Eversion
- Passive Inversion
- Plantar Flexion
- 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)
- 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)
- Management
- Relative rest
- Hard-soled shoe (indicated if pain is severe)
- References
- Achar (2019) Am Fam Physician 99(10): 610-8 [PubMed]