Review Note

Musculoskeletal: Foot and Ankle

Case: Follow-up plain films in a patient with midfoot pain.

Yellow arrows: solid-appearing {{c2::periosteal}} reaction

Red arrow: fracture {{c3::lucency/line}}

Diagnosis: {{c1::healing stress fracture of the 2nd metatarsal diaphysis.}}

Metatarsal stress fracture: Initial radiographs demonstrate extremely subtle periosteal reaction and
endosteal thickening (yellow arrow) of the lateral cortex of the second metatarsal. MRI performed two weeks later demonstrated interval development of a fracture line (red arrow), with exuberant callus formati on, intramedullary edema, and surrounding periosteal edema. Follow-up radiographs performed aft er the MRI demonstrate interval progressive healing with solid-appearing periosteal reaction (yellow arrows) but persistently evident fracture lucency (red arrow).