Metatarsal Stress Fracture Clinical Presentation

Updated: Jan 16, 2019
  • Author: Valerie E Cothran, MD; Chief Editor: Craig C Young, MD  more...
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  • Patients usually report having increased the intensity or duration of their exercise regimen.

  • Initially, dull pain only occurs with exercise, then the condition progresses to pain at rest.

  • Pain starts diffusely, then localizes to the site of the fracture.

  • Stress fractures can be historically distinguished from a true Jones fracture, because patients with a stress mechanism as the etiology report a long history of prodromal symptoms of pain over the proximal fifth metatarsal.

  • Menstrual irregularities should be explored in female patients due to a high association between female athletics, amenorrhea, and osteoporosis — otherwise known as the female athletic triad. [13, 14]



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  • Inspect the affected foot for swelling, bruising, or warmth.

  • Inspect both feet for a side-by-side comparison.

  • Palpate the affected foot to find the point of maximal tenderness. Specifically seek to determine if the point of maximal tenderness is related to bony or soft-tissue problems.

  • Inspect the patient's athletic shoes for signs of excessive supination or excessive wear under the metatarsal heads.



See the list below:

  • Increased intensity, duration, or frequency of exercise

  • New footwear

  • Insufficient rest periods

  • Continuing to train despite pain

  • Osteopenia/osteoporosis

  • Rheumatoid arthritis

  • Neuropathic foot

  • Female athletic triad