Radiological Study on the Incidence and Clinical Importance of Os Vesalianum of 5th Metatarsal Bone

Abstract

Introduction: Os Vesalianum (OSV) is an accessory ossicle of the foot, first described by Andreas Vesalius, during 1543 in “de humani corporis fabrica”. It is located proximal to the base of the fifth metatarsal bone within the peroneus brevis tendon, rarely symptomatic, detected incidentally on routine radiographs, with an incidence of 0.1% to 5.9%. OSV has rarely been implicated as a causative factor for lateral foot pain, peroneus brevis tendonitis and is commonly been misdiagnosed on routine radiographic examination as fracture of fifth metatarsal bone, due to the lack of knowledge pertaining to it. Aim: To study the presence, incidence, location and morphology of OSV. Materials and Methods: Retrospectively, 1000 radiographs both anteroposterior and oblique view of the foot was observed for the presence, incidence, location and morphology of OSV. Statistical analysis was done by descriptive statistics. Results: In the present study, we observed an incidence of 1.5% of OSV, with predominantly round or ovoid shaped. OSV was more common in males than females in the present study, which was more often located on the posterolateral aspect of the base of fifth metatarsal and lateral to cuboid bone. Conclusion: Orthopaedician and radiologists must be aware of such bony variants in the foot and ankle, which can serve as radiological pitfalls that can cause confusion leading to wrong diagnosis and delayed management in cases presenting with history of trauma and lateral foot pain.

Keywords

• accessory ossicle
• lateral foot pain
• peroneus brevis tendonitis