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Stress fracture of the proximal phalanx of the great toe

A 12-year-old female sprinter presented complaining of a 3 or 4 month history of pain in the right great toe. Initially, the pain occurred while performing a specific exercise: sprinting in place. Physical examination revealed localized tenderness and swelling on the medial aspect of the metatarsophalangeal joint of the short right hallux valgus. The radiograph showed a clear crack at the medial base of the proximal phalanx of the great toe (Fig. lA). A Tc-99m bone scan was performed. The findings obtained showed a localized increase in tracer concentration at the same place (Fig. 1B). The only treatment prescribed was a prohibition of taking exercise. Her symptoms gradually resolved and she returned to her training 2 months after the initial visit. Seven months later, the fracture was completely healed radiologically (Fig. 2).