Apophysitis an der Basis des Os metatarsale 5 (Iselin-Krankheit)
Iselin’s
disease in a Thai boxer. Absence of union of the secondary ossification centre of the base of the fifth metatarsal (black arrow).
Iselin’s
disease in a Thai boxer. Sagittal fat-suppressed T2-weighted images show bone marrow oedema at the secondary ossification centre (black arrow) and at the adjacent metaphysis of the fifth metatarsal (white arrowhead).
Iselin’s
disease in a Thai boxer. Axial T1-weighted images show widening of the growth plate between the secondary ossification centre and the base of the fifth metatarsal (white arrow).
Iselin
disease • Iselin disease: traction apophysitis base of the 5th metatarsal - Ganzer Fall bei Radiopaedia
Iselin
disease • Iselin disease: traction apophysitis base of the 5th metatarsal - Ganzer Fall bei Radiopaedia
Iselin
disease • Traction apophysitis of the fifth metatarsal base with an avulsion fracture - Ganzer Fall bei Radiopaedia
Iselin
disease • Iselin disease - Ganzer Fall bei Radiopaedia
Iselin
disease • Iselin disease - Ganzer Fall bei Radiopaedia
Iselin
disease • Iselin disease - Ganzer Fall bei Radiopaedia
Iselin disease is a benign and self-limiting condition, defined as apophysitis of the base of the 5 metatarsal.
Epidemiology
It is most commonly seen in males with sport injuries and is often also seen in adolescents.
Pathology
It is due to repetitive traction of the peroneus brevis tendon at the site of its attachment. Predisposing factors are jumping and running.
Radiographic features
Plain radiograph
- obliquely oriented small bony fleck at the base of the 5th metatarsal which is best seen on oblique radiograph
- apophyseal irregularity
MRI
Usually not considered essential for the diagnosis. But if performed may show:
- T2/STIR: high signal intensity around base of 5metatarsal due to bone marrow edema
History and etymology
First described by Hans Iselin (1878-1953) a German surgeon working in Basel, Switzerland, in 1912 .
Differential diagnosis
On imaging consider:
- normal apophysis
- accessory ossicle (e.g. os vesalianum or os peroneum)
- stress fracture
- Jones fracture
Siehe auch:
Assoziationen und Differentialdiagnosen zu Apophysitis an der Basis des Os metatarsale 5 (Iselin-Krankheit):
normale
Apophyse proximal am Os metatarsale 5
Stressfraktur
5. Mittelfußknochen
