SET T0011 -
Emergency Department

Abnormal.

Fracture of the base of the 5th metatarsal.

A common consequence of an inversion injury to the ankle. The Peroneous Brevis tendon pulls on the base of the 5th metatarsal and a fracture results. Often best shown on a lateral radiograph of the ankle joint obtained following a history of " twisted ankle ".

See : Accident & Emergency Radiology : A Survival Guide (3rd edition) : Pages 276 and 298

Both patients show a Jones fracture. This has a very different clinical connotation to that of the common or garden fracture of the base of the 5th metatarsal (the "  Peroneus Brevis fracture "). Some Jones' fractures are the result of an acute injury. Others are stress fractures. These fractures can heal slowly, sometimes very slowly . . .

See : Accident & Emergency Radiology : A Survival Guide (3rd edition) : Page 301

Normal.

The apophysis at the base of the 5th metatarsal occurs in all youngsters; its radiographic appearance can be rather variable and it frequently shows multicentric ossification.

Abnormal.

• Fracture of the base of the 5th metatarsal (MT). The fracture is the horizontal line.
• This young patient shows the expected apophysis at the base of the 5th MT. Is this apophysis slightly avulsed? Difficult to say - the normal apophysis does vary in appearance between people. Multicentric ossification is common.