What is the role of radiography in the workup of metatarsal stress fractures?

Updated: Jan 16, 2019
  • Author: Valerie E Cothran, MD; Chief Editor: Craig C Young, MD  more...
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Answer

See the list below:

  • Plain-film radiography

    • Radiographs may be negative early in the process. [13, 15]

    • Stress-fracture changes may not be evident on plain films until 3 months after the onset of symptom(s).

    • Up to 50% of stress fractures are never observed on plain films.

    • Plain-film radiographs can help the physician distinguish fifth-metatarsal stress fractures from true Jones fractures. Fractures with a stress etiology show a widened fracture line, intramedullary sclerosis, and periosteal reaction (see the images below).

      Radiograph of the feet. This image depicts a stres Radiograph of the feet. This image depicts a stress fracture of the left second metatarsal with exuberant callus.
      Radiograph of the left foot. This image depicts a Radiograph of the left foot. This image depicts a stress fracture of the fifth metatarsal.

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