What is the diagnosis for a 23-year-old female experiencing pain along the base of the 5th metatarsal with bruising, but a negative X-ray for fracture, after returning to running?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 8, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for 23-year-old Female with Pain along the Base of the 5th Metatarsal

  • Single most likely diagnosis
    • Peroneal Tendinosis or Peroneus Brevis Tendinitis: This condition is common in runners, especially after a period of increased activity. The pain and bruising along the base of the 5th metatarsal are consistent with this diagnosis, as the peroneal tendons run along this area.
  • Other Likely diagnoses
    • Cuboid Syndrome: This condition involves inflammation of the cuboid bone and surrounding tissues, which can cause pain along the base of the 5th metatarsal. It is often seen in runners and can be caused by overuse or poor foot mechanics.
    • 5th Metatarsal Stress Reaction: Although the x-ray was negative for a fracture, a stress reaction (early stage of a stress fracture) is still possible. This condition can cause pain and bruising in the affected area.
    • Peroneal Tenosynovitis: Inflammation of the tendon sheath surrounding the peroneal tendons can cause pain and swelling along the base of the 5th metatarsal.
  • Do Not Miss diagnoses
    • Compartment Syndrome: This is a serious condition that can cause pain, swelling, and bruising in the foot and ankle. It is often seen in athletes and can be caused by increased pressure within the muscle compartments.
    • Deep Vein Thrombosis (DVT): Although less likely, DVT can cause pain and swelling in the foot and ankle, and it is essential to consider this diagnosis, especially if the patient has a history of blood clots or is taking oral contraceptives.
  • Rare diagnoses
    • Tumor or Cyst: A tumor or cyst in the foot can cause pain and bruising, although this is a rare possibility.
    • Infection: An infection, such as osteomyelitis or septic arthritis, can cause pain, swelling, and bruising in the foot and ankle, although this is unlikely without other symptoms such as fever or redness.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.