title: Osteochondral lesion of the fifth metatarsal head in a triathlete.
abstract: Osteochondral lesions (OCLs) are rare joint disorders, typically found in the larger joints of the body and less so in smaller joints (J Bone Joint Surg Am 41-A:988-1020, 1959; Arthroscopy 6(3):190-197, 1990; Clin Orthop Relat Res 148:245-253, 1980). Although their specific cause is subject to frequent debate, they are often caused by trauma with subsequent compromise of the articular cartilage (Arthroscopy 6(3):190-197, 1990; J Bone Joint Surg Am 78(3):439-456, 1996). Symptoms are typically attributable to a mechanical defect, either of the bony defect or a flap of cartilage. The current case report describes an osteochondral lesion of the head of the fifth metatarsal which is a heretofore unreported location. Magnetic resonance imaging (MRI) of the lesion revealed a notable subchondral bone signal change, indicating a possible synovial fluid pressure phenomenon rather than a mechanical defect.
authors.affiliation: Hospital for Special Surgery, East 70th Street, New York, NY 10021, USA. OLoughlinP@hss.edu
authors.forename: P F
authors.initials: PF
authors.lastname: O'Loughlin
authors.forename: T I
authors.initials: TI
authors.lastname: Carter
authors.forename: C W
authors.initials: CW
authors.lastname: Hodgkins
authors.forename: J G
authors.initials: JG
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use; D001265:Athletic Injuries / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D018409:Foot Injuries / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries*; D010007:Osteochondritis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine