Iselin disease

Iselin’s
disease in a Thai boxer. Absence of union of the secondary ossification centre of the base of the fifth metatarsal (black arrow).
www.eurorad.org • CC by-nc-sa-4.0
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).
www.eurorad.org • CC by-nc-sa-4.0
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).
www.eurorad.org • CC by-nc-sa-4.0
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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:

Siehe auch:
Assoziationen und Differentialdiagnosen zu Apophysitis an der Basis des Os metatarsale 5 (Iselin-Krankheit):
Avulsionsfraktur
Basis Metatarsale 5
Wikipedia • CC BY-SA 4.0
Stressfrakturen
der Apophysen
www.eurorad.org • CC by-nc-sa-4.0
Jones-Fraktur
 
Wikipedia • CC BY-SA 3.0
Os peroneum
 
Wikipedia • CC BY-SA 4.0
akzessorische
Knochen Fuß
Wikipedia • CC0