Iselin’s disease — outer-foot pain in active kids.
Pain on the outside of the foot, just below the bony bump at the base of the fifth toe, in a 10-14 year old playing sport regularly. Iselin’s disease is an uncommon but treatable apophysitis affecting the base of the fifth metatarsal.
What Iselin’s disease is.
Iselin’s disease is an apophysitis — irritation of the growth plate at the base of the fifth metatarsal, where the peroneus brevis tendon attaches. Like Osgood-Schlatter and Sever’s, it’s caused by the repetitive pull of a strong tendon on a growth plate that’s still soft and growing.
Most common in 10-14 year olds playing impact and cutting sports — soccer, AFL, netball, basketball, dance. The peroneus brevis tendon contracts forcefully every time the child changes direction or pushes off the outside of the foot, which is what irritates the underlying growth plate.
Pain is felt over the bony bump on the outside of the foot, sometimes with mild swelling and tenderness on palpation. Usually worse with activity and better with rest. Like all paediatric apophysitis conditions, self-limiting once the growth plate fuses (usually by 16 years).
Six elements of Iselin’s management.
Same principles as other paediatric apophysitis conditions — manage the load, protect the growth plate, keep the child in sport at a sustainable level.
Three steps from first visit to outcome.
