Ultrasound Diagnostic: Rapid Detection of Second Metatarsal Stress Fracture, Case Report and Literature Study

Ultrasound is extensively used for soft tissue pathology. Scanning bone superficial structures may reveal clear pathologic features to aid diagnosis.

We present the case of a stress fracture in the second metatarsal, with the clinical aspect of a gouty attack. Ultrasound examination showed cortical thickening and disruption, hypoechoic periosteal swelling, hyperemia, soft tissue edema, and displacement of the extensor tendon. The diagnosis was confirmed by X-ray and MRI. The value of different diagnostic tools is discussed, and the importance of gray-scale and color Doppler ultrasound as a first-hand modality is underlined.

Sonography clearly identifies cortical and periosteal abnormalities, differentiates surrounding soft tissue pathologies, and offers dynamic evaluation, and follow-up possibility with low cost, high accessibility, and no risks. Periosteal and cortical irregularities are important diagnostic issues when performing ultrasound examinations for soft tissue pathology.