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Metatarsal fracture x ray8/28/2023 ![]() This creates numerous microfractures especially when the duration, intensity or frequency of physical activity is rapidly increased. The pathogenesis of stress fractures is due to a cyclic, repetitive and submaximal loading of the bone. Stress fractures at the base of the first or second metatarsals or affecting other metatarsal bones are less common. Insufficiency fractures occur more commonly in the elderly and, in particular, in oncology patients.Īmong the metatarsal bones, stress fractures involving the middle and distal portions of the shaft of the second and third metatarsals are most common. Incidence of fatigue fractures is increasing in the population, with runners now the most commonly affected group, accounting for 72% of stress fractures. They are classified into two groups: those that result from prolonged cyclical mechanical stress on normal bone are called "fatigue fractures", while those that occur with physiologic stress on bones weakened by metabolic disease or radiation treatment are called "insufficiency fractures". Stress fractures occur in normal or metabolically weakened bones. No therapy was recommended (only oral FANS to relieve the pain). These clinical, X-Ray, CT and MR features were compatible with SEQUENTIAL stress fractures (unusual presentation for multiple stress fractures, which normally occur together). Moreover there was diffuse oedema of soft tissues. SE T1 confirmed the presence of the two fracture lines and STIR showed areas of bone marrow oedema within the proximal portion of the shaft of the first and second metatarsals, within the distal portion of the shaft of the third metatarsal bone and within the head of the fourth metatarsal bone. A bone metabolism investigation was performed (negative).Ī MRI examination was performed (about one month later) in order to study soft tissues of the foot and bone marrow of the metatarsal bones. The patient underwent X-ray that showed a fracture of the second metatarsal bone she was treated with partial weight bearing.Īfter 2 months, due to the persistence of pain, the patient underwent a CT examination which confirmed the presence of the second metatarsal bone fracture and it also showed the presence of a fracture within the third metatarsal bone. The patient's investigation was negative for any bone metabolic disease. ![]() The pain was more relevant at weight bearing. The patient presented with metatarsalgia lasting for one month. ![]()
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