Os Vesalianum Pedis

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The os vesalianum pedis (to be differentiated from the os vesalianum manius in the hand) is an uncommon accessory bone that is seen in less than 0.5% of the population. It is located within the peroneus brevis tendon adjacent to the tip of a well-developed tuberosity of the fifth metatarsal and articulates with the cuboid. It is rarely symptomatic.

Differential considerations include:

• Avulsion fracture: Oriented in the transverse plane.
• Normal ossification center: The normal ossification center of the tuberosity of the fifth metatarsal is oriented parallel to the metatarsal shaft.
• Iselin disease: Traction apophysitis at the base of the fifth metatarsal. Similar to Osgood Schlatter disease, ossicles can break free, resulting in a fragmented appearance.

References

• Gillespie H. Osteochondroses and apophyseal injuries of the foot in the young athlete. Curr Sports Med Rep. 2010 Sep-Oct;9(5):265-8.
• Mellado JM, Ramos A, Salvadó E, Camins A, Danús M, Saurí A. Accessory ossicles and sesamoid bones of the ankle and foot: imaging findings, clinical significance and differential diagnosis. Eur Radiol. 2003 Dec;13 Suppl 4:L164-77. Review.