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.
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