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Osteoid Osteoma at the Proximal Diaphysis of the Fifth Metatarsal

A Case Report

Muhammet Baybars Ataoglu Department of Orthopaedics and Traumatology, Gazi Üniversitesi School of Medicine, Ankara, Turkey. Dr. Ali is now with the Department of Orthopaedics and Traumatology, Kirkuk University School of Medicine, Azadi Training Hospital, Kirkuk, Iraq.

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Ali Kh. Ali Department of Orthopaedics and Traumatology, Gazi Üniversitesi School of Medicine, Ankara, Turkey. Dr. Ali is now with the Department of Orthopaedics and Traumatology, Kirkuk University School of Medicine, Azadi Training Hospital, Kirkuk, Iraq.

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Mustafa Ozer Department of Orthopaedics and Traumatology, Hacı Şaban Mah. Meram Yeniyol Caddesi No:97, Meram, Turkey. Dr. Ozer is now with the Department of Orthopaedics and Traumatology, Necmettin Erbakan University School of Medicine, Konya, Turkey.

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Hüseyin Nevzat Topcu Department of Orthopaedics and Traumatology, Sanliurfa Teaching and Research Hospital, Sanliurfa, Turkey. Dr. Topcu is now with Sakarya University Training and Research Hospital, Sakarya, Turkey.

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Mehmet Cetinkaya Department of Orthopaedics and Traumatology, Erzincan University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey.

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Gamze Kulduk Department of Pathology, Gazi Üniversitesi, Ankara, Turkey. Dr. Kulduk is now with the Department of Pathology, Dortcelik Children's Hospital, Bursa, Turkey.

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The foot is rarely the focus of osteoid osteoma, and only a few of those cases are related to the fifth metatarsal. The present case demonstrates that atypical symptoms with suspicious findings on plain radiographs that are not associated with trauma must be analyzed carefully to determine the nature of the lesion and perform the precise treatment to obtain and sustain the cure. A 29-year-old man presented to the outpatient clinic with a 2-year history of chronic pain in the lateral aspect of his left forefoot. The onset was not related to trauma, surgery, local infection, osteomyelitis, or another entity regarding the proximal fifth metatarsal. The patient noted that the pain was aggravated at night and typically subsided with the use of salicylates or other nonsteroidal anti-inflammatory drugs. Initial plain radiographs demonstrated cortical thickening and a lytic lesion at the proximal diaphysis of the fifth metatarsal. Because the pain relief was transient, we suspected an osteoid osteoma lesion, and subsequent magnetic resonance imaging manifested pathognomonic signs of subperiosteal osteoid osteoma. Diagnosis was followed by planning of the surgery that ended the patient's symptoms.

Corresponding author: Mehmet Cetinkaya, Department of Orthopaedics and Traumatology, Erzincan University Mengücek Gazi Training and Research Hospital, Başbağlar Street, Center of City, Erzincan, Erzincan 24010, Turkey. (E-mail: drcetink@gmail.com)