Chowchuen P, Resnick D
Department of Radiology, Faculty of Medicine, Khon Kaen University, Thailand.
Skeletal Radiol. 1998 Jan;27(1):22-5. doi: 10.1007/s002560050329.
To describe the imaging characteristics of stress fractures of the heads of the metatarsal bones, emphasizing their difference from the more common metatarsal shaft and neck stress fractures.
Eight patients with stress fractures of the head of one or more of the metatarsal bones were seen in a 5-year period. The four men and four women were 31-72 years of age (mean 52.3 years). Three of the patients were active in sports. Three patients had underlying conditions predisposing to insufficiency fracture and one patient had had a bunionectomy on the affected foot 5 years previously. Plain radiographs and magnetic resonance (MR) imaging studies were reviewed in a retrospective feature.
Plain radiographs showed subchondral sclerosis of the metatarsal heads in all but one case, in which MR imaging, performed 6 weeks after the onset of symptoms, demonstrated an area of abnormal signal intensity in the head of the third metatarsal bone consistent with marrow edema.
Stress fractures (i.e., fatigue and insufficiency fractures) of the head of the metatarsal bones occasionally occur. Because of their less recognized appearance on routine radiographs and MR images, they are frequently overlooked.
描述跖骨头应力性骨折的影像学特征，强调其与更常见的跖骨干和颈部应力性骨折的差异。
在5年期间共诊治了8例一个或多个跖骨头应力性骨折患者。其中4名男性和4名女性，年龄31 - 72岁（平均52.3岁）。3例患者积极参加体育活动。3例患者有易发生不全骨折的基础疾病，1例患者5年前在患足行拇囊炎切除术。回顾性分析平片和磁共振（MR）成像研究。
除1例患者外，所有患者的平片均显示跖骨头软骨下硬化，该例患者在症状出现6周后行MR成像检查，显示第三跖骨头区域异常，符合骨髓水肿表现。
跖骨头应力性骨折（即疲劳性和不全骨折）偶尔发生。由于其在常规X线片和MR图像上表现不典型，常被忽视。
