Pediatric Fifth Metatarsal Apophysis Fracture

  • Etiology: Traction apophysitis of tuberosity of fifth metatarsal caused by repetitive traction of peroneus brevis tendon at the site of its attachment
  • Imaging Radiograph: Irregularity and fragmentation of the apophysis of the fifth metatarsal
  • DDX: Fracture of the base of the fifth metatarsal
  • Complications:
  • Treatment:
  • Clinical:
    — Seen in physically active children between 9-14 years old
    — Presents with lateral midfoot pain aggravated by sports activities

Radiology Cases of Fifth Metatarsal Apophysis Fracture

Radiograph of apophyseal fracture of the fifth metatarsal
AP radiographs of the feet show asymmetrically increased fragmentation of the left fifth metatarsal apophysis when compared to its counterpart on the right. This was also the point of maximal tenderness on physical exam.
Radiograph of fracture of the apophysis of the fifth metatarsal
AP (left) and oblique (right) radiographs of the foot show fragmentation of the apophysis of the fifth metatarsal and displacement of it away from the fifth metatarsal.