A 45 year old presented with ongoing pain around the outside of the midfoot. There was focal pain with palpation of the 4th metatarsal.
There was a 4th metatarsal stress fracture which was present when ultra sounding the metatarsal. There was a disruption in the cortex of the metatarsal with swelling of the periosteum.
Treatment options include:
– Cessation of high impact activity
-Wearing a more supportive solid shoe
-Orthotic insoles
– CAM walker immobilisation.