A 28-year-old female triathlete presented to her physician because of pain in the left forefoot that had been present for several months and was interfering with her training.
On physical examination there was tenderness in the region of the distal aspect of the third metatarsal. No swelling or signs of inflammation were noted. Plain radiographs were unremarkable as was a radioistope bone scan. The patient subsequently underwent magnetic resonance imaging. Fig. 1 is an axial STIR (short tau inversion recovery) image through the left forefoot. Figs. 2 and 3 are pre-contrast- and post-contrast-enhanced T1-weighted axial images through the same region.
What is the diagnosis?
For the answer and a discussion of the condition see page 467.
Footnotes
Inquiries about this section should be directed to the section editor: Dr. Peter L. Munk, Professor, Department of Radiology, Vancouver General Hospital and Health Sciences Centre, 855 West 12th Ave., Vancouver BC V5Z 1M9; plmunk{at}interchange.ubc.ca