Dr Foot Discussion

[Dr Foot]

Dear Dr. Foot,

For the past month my ten year old daughter has complained about this painful lump on the side of her foot. It seems to be about where her 5th metatarsal bone is. She is very active. She pitches for our local softball team and also is very involved in dance and gymnastics. Her pain is getting worse day by day. She has an upcoming dance revue that she is very determined to perform in. What can this be? She has not had any evident foot trauma. Any suggestions on what this could be? ???

[Dr Foot]

Hello, does she have visible signs of lesions (corns, hard skin) or trauma (bruising). If not then she may require x-rays. I have seen young patients that develop metatarsal stress fractures or Freiberg's Infraction which is a condition specific to the lesser metatarsal heads, most commonly the second metatarsal but can occur to other metatarsals. X-rays will confirm if she has a stress fracture or avascular necrosis of the head of the 5th metatarsal. It does not require a traumatic event such as a fall for this to occur. It could be cumulative trauma to a specific area of the foot. Visit a state registered chiropodist also for a biomechanical evaluation to assess if her gait (walking and running pattern) are normal. She may require insoles and she will most definitely require a removal pad or redistributive insoles that take the pressure away from the 5th metatarsal.

Have you read about kohlers disease? It usually occurs in boys and at a young age but it has been known to affect teenage girls.

kholers

click below
http://www.drfoot.co.uk/Osteokohl.htm