Tuesday, September 4, 2018

There are multiple fractures involving the base of the fifth metatarsal. Today's case is a Pseudo-Jones fracture, which otherwise represents an avulsion fracture, often related to a forcible inversion of the foot in plantar flexion, resulting in the peroneus brevis ripping of the bony protuberance at the base of the 5th metatarsal. In my younger days, I had one of these after a sweet, fade-away jump shot during a charity basketball tournament. Those were the days, but I digress. When progressing more distally along the 5th metatarsal, approximately 2 cm in the region of the metadiaphyseal junction, you'll have the traditional Jones fracture. This represents an extra-articular, transverse fracture of the metatarsal shaft.  Here is the same patient's ankle radiographs, which also demonstrate the fracture.






Here is a subtle, but real Jones fracture in another patient, who initially only received ankle radiographs. On how many views can you see the fracture?






Radiopedia has a great write up about these fractures and the proximal 5th metatarsal apophysis (remember: it will be longitudinal and parallel to the 5th metatarsal shaft).



Case courtesy of Dr Andrew Dixon, Radiopaedia.org. From the case rID: 7644