An Unusual Presentation Of Foot Pain In A Soccer Player - Page #1

Author: Adam Maghrabi, MD
Co Author #1: Adam Maghrabi, MD
Co Author #2: John Hill, MD
Co Author #3: Laura McIntosh, MD

Patient Presentation:
A 24 year old male soccer player presented with a limp to his ATC after experiencing a painful pop of his left lateral foot while making a pivoting maneuver during a game.

Sideline exam revealed bony tenderness at left proximal 5th metatarsal. X-ray was ordered and he was placed in a walking boot pending results. A few days later he followed up in the training room with the team physician. At that time he was feeling considerably better. The left foot x-ray showed a transverse lucency with smooth edges at the base of the 5th metatarsal compatible with a possible subacute fracture. Case Photo #2 He was instructed to remain in the walking boot for 2 weeks. The pain improved, but when he transitioned out of the boot, the pain recurred with activity and he started limping again.

Physical Exam:
Healthy appearing male in no distress. Left foot inspection was normal without swelling or deformity. His active and passive plantarflexion and dorsiflexion were very mildly restricted, otherwise normal ankle range of motion and strength. There was mild tenderness along the peroneal tendons and the base of 5th metatarsal. Tuning fork exam was negative. Sensation to light touch was intact and distal pulses were good. He had very mild discomfort with single leg stance hop. Right foot and ankle exam was grossly normal.

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