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Avulsion Fracture of the Base of the Fifth Metatarsal Not Seen on Conventional Radiography of the Foot

The Need for an Additional Projection

¹ All authors: Department of Radiology, University of Virginia Medical System, Box 170, Charlottesville, VA 22908.

View larger version (72K): [in a new window]   Fig. 1A. —28-year-old woman with avulsion fracture of base of fifth metatarsal. Anteroposterior (A), anteroposterior oblique (B), and lateral (C) digital radiographs of foot fail to reveal fracture of base of fifth metatarsal.

View larger version (69K): [in a new window]   Fig. 1B. —28-year-old woman with avulsion fracture of base of fifth metatarsal. Anteroposterior (A), anteroposterior oblique (B), and lateral (C) digital radiographs of foot fail to reveal fracture of base of fifth metatarsal.

View larger version (67K): [in a new window]   Fig. 1C. —28-year-old woman with avulsion fracture of base of fifth metatarsal. Anteroposterior (A), anteroposterior oblique (B), and lateral (C) digital radiographs of foot fail to reveal fracture of base of fifth metatarsal.

View larger version (87K): [in a new window]   Fig. 1D. —28-year-old woman with avulsion fracture of base of fifth metatarsal. Anteroposterior (D) and anteroposterior oblique (E) digital radiographs of ankle show fracture of tip of tuberosity (arrow).

View larger version (73K): [in a new window]   Fig. 1E. —28-year-old woman with avulsion fracture of base of fifth metatarsal. Anteroposterior (D) and anteroposterior oblique (E) digital radiographs of ankle show fracture of tip of tuberosity (arrow).

View larger version (96K): [in a new window]   Fig. 2A. —61-year-old woman with avulsion fracture of base of fifth metatarsal and oblique fracture of distal fibula. Avulsion fracture was not seen on foot radiographs (not shown). Anteroposterior digital radiograph of ankle shows fracture of tip of tuberosity (straight arrow). Oblique fracture of distal fibula (curved arrow) is also visible.

View larger version (108K): [in a new window]   Fig. 2B. —61-year-old woman with avulsion fracture of base of fifth metatarsal and oblique fracture of distal fibula. Avulsion fracture was not seen on foot radiographs (not shown). Anteroposterior oblique digital radiograph of ankle shows subtle radiolucency at fracture site of base of fifth metatarsal (straight arrow), which is more conspicuous on anteroposterior radiograph (A). Oblique fracture of distal fibula (curved arrow) is also visible.

View larger version (12K): [in a new window]   Fig. 3. —Anatomy of proximal fifth metatarsal. Drawin shows relationships among base of fifth metatarsal, lateral cord of plantar aponeurosis (straight arrow) and peroneus brevis tendon (curved arrow).

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