Age / Sex : 37 / M

Age / Sex : 37/M
Chief complaint :

Recurrent pain at the dorsal aspect of right mid foot for several years

Past trauma Hx. (-)

1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

* Send Application Answers to In Sook Lee, MD (lis@pusan.ac.kr)

Courtesy :

Os intermetatarseum

Discussion

Findings:

A small ossicle between base of 1^st and 2^nd metatarsal bone and 1^st cuneiform bone in the right foot.

Differential Diagnosis:

Small fractures involving the base of the second metatarsal bone (Lisfranc fracture dislocations)

 Diagnosis: Os intermetatarseum

Discussion: Accessory ossicles & sesamoid bones

•      Most : developmental abnormalities

•      Incidental radiographic findings

•      Accessory ossicles

–      Derive unfused accessory ossification centers

•      Most accessory ossicles and sesamoid bones of the ankle and foot à asymptomatic!!!

•      Overuse and trauma à painful syndromes or degenerative changes

n  Os intermetatarseum: Between the medial cuneiform and the base of the first and second metatarsals

 Round or spindle shaped

References:

–      Seminars in Musculoskeletal Radiology, Volume 6, Number 2, 2002.

–      Eur Radiol (2003) 13:L164–L177

–      Surg Radiol Anat (2009) 31:19–24

–      American  Journal of  Physical  Anthropology 107:199–209 (1998)