Abstract
Os vesalianum pedis is a rare accessory foot ossicle. It is usually asymptomatic, however, it can be an infrequent cause of lateral foot pain. We present the case of a 19-year-old healthy male with lateral foot pain after an inversion-type injury. Initial X-rays were mistaken for fracture of the fifth metatarsal, however, a high index of suspicion for the presence of the os vesalianum led us to perform imaging of the contralateral foot; a mirror image with contralateral os vesalianum was revealed. The patient was treated conservatively and had an excellent outcome. In the context of trauma, os vesalianum must be differentiated from other causes of lateral foot pain, such as Iselin’s disease, avulsion fracture of the fifth metatarsal, Jones fracture, and others. Os vesalianum pedis is characterized as a rounded ossicle, with smooth edges, surrounded by cortical bone. Prompt diagnosis is essential as it changes the management.
Highlights
Os vesalianum pedis (OVP) is one of the many accessory bones which can be found in the human foot
In the context of trauma, os vesalianum must be differentiated from other causes of lateral foot pain, such as Iselin’s disease, avulsion fracture of the fifth metatarsal, Jones fracture, and others
We present a rare case of OVP that became symptomatic after an acute ankle sprain
Summary
Os vesalianum pedis (OVP) is one of the many accessory bones which can be found in the human foot. OVP is a rare accessory ossicle of the foot with incidence ranging between 0.1% and 5.9% [1,2,3] It is mostly asymptomatic and incidentally recognized. A 19-year-old healthy male was admitted to the emergency department of our hospital complaining of lateral foot pain He reported minor trauma, with possible inversion-type injury of the lateral foot a few hours before the ER admission. Plain radiographic examination (anteroposterior {AP} and lateral oblique radiograph) of the left foot showed a bean-shaped oval bone fragment at the fifth metatarsal base (Figure 1). This initial radiographic imaging was perceived as an acute fracture of the fifth metatarsal base. The Foot and Ankle Disability Index (FADI) score was again 104 points (100%), so the patient was discharged from our care
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