Point of care ultrasound for assessment of Osseous injury.
A 49 year old lady visited clinic 360 with well localised dorsal sided mid-foot pain that began 2 weeks prior. She was a keen runner. An x-ray had already been organised which was reported as normal.
The sonographic images show a clear discontinuity of the chondral surface of the 2nd MTP shaft with adjacent hyperaemia, in keeping with a stress fracture.
Though there are limitations in the assessment of bony pathology with ultrasound, this imaging modality is highly sensitive at assessing for chondral injuries that can easily be missed on plain radiograph.