Iselin's disease

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Related to Iselin's disease: os vesalianum
Iselin's disease osteochondritis or traction apophysitis of styloid process of fifth metatarsal; typically affecting athletic teenage children (see Table 1and Table 2; apophysitis; osteochondritis)
Table 1: Classifications of osteochondritis in the lower limb
Criterion 11. OC of the primary articular epiphysis (e.g. Freiberg's disease of the metatarsal head; Kohler's disease of the navicular)
2. OC of the secondary articular epiphysis (e.g. osteochondritis dissecans of the talus)
3. OC of the non-articular epiphysis (e.g. Osgood-Schlatter disease of the tibial tuberosity; Iselin's disease of the styloid process of the fifth metatarsal)
Criterion 21. Crushing apophysitis (e.g. Freiberg's disease) where the pressure of the base of the adjacent phalanx causes an 'eggshell fracture' of the affected metatarsal head
2. Traction or distraction apophysitis (e.g. Sever's disease; Iselin's disease; Osgood-Schlatter disease) where traction at the tendon insertion distracts a secondary centre of ossification from the body of the calcaneum, fifth metatarsal or tibia respectively
3. Fragmentation apophysitis (e.g. osteochondritis dissecans) in which the cortical bone overlying the enchondral defect fractures and separates to create a loose body within the joint
Two criteria may be used to classify osteochondritis:
• criterion 1 relates to the anatomical location of the enchondral ossification defect
• criterion 2 relates to the effects on the diseased bone brought about by the local forces that act on the bone.
Table 2: Presentations of osteochondritis/osteochondrosis in the leg and foot
OCSite affectedTypeAge of onset (years)
Blount's diseaseProximal tibial epiphysisUnderdevelopment of medial epiphysis1-3; 6-13
Buschke's diseaseCuneiformsOssification anomaly11-15
Freiberg's diseaseSecond/third metatarsal headCrushing OC12-18
Iselin's diseaseBase of fifth metatarsalTraction apophysitis11-15
Kohler's diseaseNavicularCrushing OC3-7
Legg-Calve-Perthe diseaseCapital femoral epiphysisTrue OC2-16
Osgood-Schlatter diseaseTibial tuberosityTrauma-related11-15
Osteochondritis dissecansTalar dome
Lateral femoral condyle of knee
Sever's diseaseCalcaneal apophysisTraction apophysitis10-14
Sinding-Larson-Johansson diseasePatellaTraction apophysitis10-14
Treve's diseaseSesamoids (1 MTPJ)True OC15-20

1 MTPJ, first metatarsophalangeal joint.