Reason: Possible AVN 4th metatarsal History: TTP about 4th metatarsal Note is made of a linear focus of decreased signal abnormality traversing the tuberosity of the base of the fifth metatarsal indicating a nondisplaced fracture. There is a small amount of bone marrow edema in the surrounding area. Additionally, note is made of a lesion within the proximal fourth metatarsal which demonstrates increased signal abnormality on T2-weighted images and decreased signal abnormality on T1-weighted images likely representing an enchondroma, although this is incompletely characterized on this noncontrast examination. A skin marker is identified and the overlying area, presumably corresponding to the patient's area of concern. There is minimal associated endosteal scalloping. No definite cortical destruction is identified. No definite fracture is identified within the fourth metatarsal. The imaged musculature of the right foot is within normal limits. The flexor and extensor tendons appear intact. Mild osteoarthritis affects the imaged midfoot articulations.
1. Nondisplaced fracture through the base of the fifth metatarsal as described above.2. Lesion within the base of the fourth metatarsal likely represents a benign enchondroma. However, CT examination is recommended for further characterization, particularly given the stated history of fourth metatarsal pain. 3. Osteoarthritis of the midfoot.