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Hi

In the absence of neurological disorders how prevalent is this?

I have seen a patient c/o pain in 4th met with some dorsal oedema.

female 20's

Normal childhood milestones

All vaccinations

Mother says no history of high arched feet or floppiness!!

H/o stress fracture 2008 - untreated by previous podiatrist.

XRAY WB and NWB - show healed 2nd met stress fracture. No obvious fracture. Confirms unilateral high arch. (i have not seen the xray as yet)

Ligament laxity -elbows/knees etc

genu recurvartum

genu valgum

Recently started running as Obese - mild pain prior to this but obviously worse now

Lower back pain. (Not convinced all normal here) I have advised them to ask physio to review this

Legs seem to have champagne flute appearance but this is both legs.

I obviously have a few suspicions here but dont want to jump the gun or unduly concern anyone.

Thoughts and opinions would be good. I will be seeing them again within the next week or so

Be gentle please!! Tried to remember as much as i can

 

If the 4th metatarsal is painful, then what pathologies could it be?
If she's had a previous stress fracture, i'd be thinking another stress fracture. Xrays can be inconclusive for a few months.

From the info you've given, i'd put her in an aircast for a few weeks and let it calm down. Long term- once its healed, custom orthotic with modifications to reduce bending forces on metatarsals.

What are your suspicions? Neurological conditions? CMT?