Cuneiform stress fracture as a complication of plantar fasciitis

NewsBot · Jul 31, 2009

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Magnetic resonance imaging of stress injury of the cuneiform bones in patients with plantar fasciitis.
Bui-Mansfield LT, Thomas WR.
J Comput Assist Tomogr. 2009 Jul-Aug;33(4):593-6.

OBJECTIVE: The authors reported the magnetic resonance (MR) appearance of stress fractures of the cuneiform bones in patients with plantar fasciitis and performed a review of the literature on stress fractures associated with plantar fasciitis. MATERIALS AND METHODS: The authors performed a retrospective review of their experience with 5 cases of cuneiform stress fractures and associated plantar fasciitis. The medical records and MR examinations were reviewed. A literature search was performed on the PubMed search engine. RESULTS: There were 5 patients (1 man and 4 women) with stress fractures of at least 1 cuneiform bone. Patients' age ranged from 41 to 77 years, and their average weight was 212 lb. All patients had heel pain and either midfoot or lateral foot pain. There were 2 intermediate, 1 medial, and 3 lateral cuneiform stress fractures seen on MR imaging in these 5 patients. Two of these patients had undergone plantar fasciotomy, and all 5 had been treated with steroid injections. CONCLUSION: Plantar fascia injury, changes in gait, large body habitus, and excessive or new onset of exercise regimens are all potential causes of cuneiform stress fractures. Although the incidence of cuneiform stress fractures is extremely rare, they may occur in patients with plantar fasciitis.
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NewsBot · Aug 29, 2020

Stress Fracture of Isolated Middle Cuneiform Bone in a Trainee Physician: A Case Report and Review
Mukesh Kumar Saini, et al
JFAS: August 28, 2020

Stress fractures are chronic fatigue failure of bone from repetitive subthreshold loads. Insufficiency fractures occur in bones that are already osteopenic and fail to withstand normal loads over time. Stress fractures of cuneiform bones are extremely rare and usually reported to happen in athletes or recruits. We describe a case of middle cuneiform insufficiency fracture that occurred in a young trainee physician with severe hypovitaminosis D, who joined his training a few weeks before it happened. Magnetic resonance imaging remains the modality of choice of diagnosis of foot stress injuries because it detects even stress reactions with reasonable sensitivity. Cuneiform stress fractures, like other low-risk stress fractures, heal with immobilization only and do not require surgical intervention.
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