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I noticed a runner just lately with a gradual onset of lateral foot ache and swelling. Signs had worsened after a race and strolling was now painful and tough. That they had no early morning stiffness however did report ache at night time. This historical past mixed with bony tenderness on palpation raised my suspicions for a fifth metatarsal stress fracture.
These are thought-about excessive threat because of the impaired blood provide in that area which might delay therapeutic. This is dependent upon the situation of the stress fracture:
Graphic tailored from Zwitser and Breederveld (2010).
Surgical procedure is typically required and it typically means a prolonged interval away from sport so in the event you suspect a high-risk stress fracture it’s greatest to rearrange an investigation asap. This can assist decide the situation and severity of the bone stress harm.
An X-ray is a wise first step to rule out a real fracture however will typically miss stress fractures. MRI is taken into account gold commonplace though fifth metatarsal stress fractures can generally be seen on ultrasound.
In case you are extremely suspicious of a stress fracture it might be vital to supply crutches and suggest a interval of partial or non-weight bearing, particularly if there’s ache whereas strolling.
In our runner’s case luckily the MRI dominated out a stress fracture which permits us to press on with rehab and be guided by signs with out concern of a extra critical harm.
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