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Radiological Cases of the Month

Gregory M. Glenn, MD; Gary T. Vallier, MD; R. Dorn, MD; J. Copp, MD; Beverly P. Wood, MD
Am J Dis Child. 1993;147(7):787-788. doi:10.1001/archpedi.1993.02160310089025.
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This 14-year-old girl was moving sound equipment for a stage band when a 180-kg rectangular trunk fell from the vertical position and struck the dorsum of her right foot. She was seen the following morning at the pediatric clinic. There was point tenderness on the dorsum of the right foot at the base of the third and fourth metatarsals, minimal erythema, bruising, and swelling. Her range of motion was intact, but with pain on dorsiflexion. The pedal pulse was strong, and sensation normal. Roentgenograms were normal. She walked with moderate difficulty and was instructed to minimize use of the foot and to use analgesics.

The next week her clinical condition was unchanged and her foot was immobilized in a cast. Two weeks later the pain persisted and no change was noted on physical examination. Roentgenograms were again obtained and were normal. Inquiries regarding her pain tolerance suggested that her pain


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