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I have a 5 year old female who has come in experiencing bilateral pain of 5th met styloid. mother mentions that it swells from time to time, especially when participating in athletics/running activities. mother mentions that swelling can be as big as a golf ball with bruising too. in initial consult young girl only felt slight tenderness but was bearable, but complains when sore. at first i thought that it could be a suspected avulsion off 5th met styloid/osteochondrosis type injury. Patient also has a pronated foot type throughout gait (walking and running). Xrays have also been done, no evidence of stress fractures.osteochondrosis etc, but just increase density within the tissue which contours the both 5th met styloid. so i thoughout it could be just the tightening of the peroneal muscles (which were actually quite tight, slightly tender). so management treatment plan was that i adviced stretching, RICE + appropriate footwear. i will be reviewing this patient within 3 weeks to see if the pain has reduced etc... but within long term treatment orthotics will be included in the treatment plan. does anyone else have any ideas with this situation? will help alot :)
Thank you craig,
Yes Iselins disease did cross my mind, so i based my management plan around it, i just wanted to make sure my diagnosis/treatment plan was on the right track. however, does it matter if there were no signs of any osteochonrosis of the 5th met styloid on the xrays?