Symptomatic os intermetatarseum in a young athlete

Abstract

The os intermetatarseum is located between the medial cuneiform and the base of the first and second metatarsals. Literature reviews have found few symptomatic cases of this condition since the 19th century. We report the case of a young female athlete, 20 years old, with sudden pain in the back of the midfoot after a jump. The os intermetatarseum is the rarest accessory bone in the foot and is typically asymptomatic. The presence of this bone should be considered when patients, especially young athletes, present with pain in the dorsum of the foot and compressive symptoms of the deep fibular nerve. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Os Intermetatarseum: A Rare Variation of Great Relevance

“…The foot is a well-known site for anatomical variations and is one of the most common regions to present supernumerary bones, ranging from 12 to 21 accessory bones (de Oliveira et al, 2018). They are usually derived from the failure of union of secondary ossification centers adjacent to the main bony mass (Keles-Celik et al, 2017).…”

“…It is a relatively uncommon anatomical variation, with a reported prevalence of around 0.1 % to 12.5 % in the general population (van Aswegen et al, 2020;Kalbouneh et al, 2021). While often asymptomatic, the os intermetatarseum can be associated with pain and other symptoms that can significantly affect quality of life (de Oliveira et al, 2018).…”

“…For patients who experience pain or other symptoms related to the os intermetatarseum, conservative treatments such as rest, ice, and physical therapy may be recommended. Non-steroidal anti-inflammatory drugs may also be used to manage pain and discomfort (Kose et al, 2014;de Oliveira et al, 2018).…”

Articulating Os Intermetatarsium with painful ganglion cyst

“…Although usually asymptomatic and found incidentally, few cases of painful os intermetatarsium have been reported (3,4,6) presenting as painful metatarsus primus (11) or with dorsal foot pain associated with paresthesia between the first and second toe exacerbated by weight-bearing, tight shoes, and activities like ball kicking. (1,3,6).…”

“…Symptoms could be due to compression of local structures or painful metatarsus primus or less commonly they could be related to a fracture of the os intermetatarsium. (1,3,4,11). We present in our case, a patient presenting with dorsal foot pain who was found to have an articulating os intermetatarsium complicated by a ganglion cyst.…”