title: Diagnosis and serial sonography of a proximal fifth metatarsal stress fracture.
abstract: OBJECTIVE
  The purpose of this report is to describe a fifth metatarsal stress fracture that was not detectable using conventional radiographs and was identified with diagnostic ultrasonography (US), confirmed with computed tomography, and followed through symptom resolution with US.
  
  
  METHODS
  A 68-year-old woman presented to a chiropractic teaching clinic for evaluation of right foot pain. Diagnostic US examination using an 8- to 15-MHz linear array transducer showed increased vascularity, periosteal elevation, and cortical disruption of the proximal diaphysis of the fifth metatarsal suggestive of a stress fracture. The patient was referred to an orthopedic specialist for comanagement.
  
  
  RESULTS
  The patient was treated by an orthopedist who confirmed a stress fracture using computed tomography, and she was fit with a short-leg walking boot. Serial US images were obtained to document fracture healing and exclude complications. After 6 months, the patient was asymptomatic and had resumed all of her daily activities.
  
  
  CONCLUSIONS
  We report a case of a proximal fifth metatarsal stress fracture that was visualized with US and followed through symptom resolution by serial examinations.
authors.affiliation: Resident, Department of Radiology, Logan University, Chesterfield, MO.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Battaglia
authors.affiliation: Director, Assessment Center, Logan University, Chesterfield, MO.
authors.forename: Martha A
authors.initials: MA
authors.lastname: Kaeser
authors.affiliation: Professor, Department of Radiology, Logan University, Chesterfield, MO.
authors.forename: Norman W
authors.initials: NW
authors.lastname: Kettner
keywords: Chiropractic; Computed tomography; Fracture; Stress; Ultrasonography