18-year-old female with pain. Evaluate for fifth metatarsal stress fracture. There is abnormal bone marrow signal within the fourth metatarsal shaft demonstrate hyperintense STIR signal intensity and relatively lower signal intensity on T1-weighted sequences when compared to the other metatarsals of the right foot. There is mild periosteal edema. This is most compatible with a stress reaction. There are no focal additional linear changes to suggest a fracture. The surrounding soft tissues, including the extensor and flexor compartment tendons and muscles appear normal.
Findings most compatible with a stress reaction of the fourth metatarsal shaft.