Paediatric orthopaedics: Iselin disease: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric orthopaedics: Iselin disease

Sample item

A 12-year-old athlete has lateral midfoot pain at the base of the fifth metatarsal that worsens with running. Radiographs show a fragmented, enlarged secondary ossification centre there. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Iselin disease

Iselin disease is a traction apophysitis of the base of the fifth metatarsal, caused by pull of peroneus brevis on the growing apophysis. It resolves with rest and activity modification once the apophysis fuses. It should be distinguished from an avulsion fracture or Jones fracture at the same site.

Option by option

  • A. Sever disease

    Sever disease is traction apophysitis of the calcaneus, causing heel pain.

  • B. Freiberg infraction

    Freiberg infraction is osteochondrosis of the second metatarsal head.

  • C. Kohler disease

    Kohler disease is osteonecrosis of the tarsal navicular in young children.

  • D. Iselin disease (correct)

    Correct. Traction on the fifth metatarsal base apophysis in an athletic child is Iselin disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Iselin disease. Iselin disease is a traction apophysitis of the base of the fifth metatarsal, caused by pull of peroneus brevis on the growing apophysis.

Why is "Sever disease" not the answer?

Sever disease is traction apophysitis of the calcaneus, causing heel pain.

Why is "Freiberg infraction" not the answer?

Freiberg infraction is osteochondrosis of the second metatarsal head.

Why is "Kohler disease" not the answer?

Kohler disease is osteonecrosis of the tarsal navicular in young children.

What concept does this question test?

It tests Paediatric orthopaedics: Iselin disease in Orthopaedics. It resolves with rest and activity modification once the apophysis fuses. It should be distinguished from an avulsion fracture or Jones fracture at the same site.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric orthopaedics: Iselin disease?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.