Paediatric Lateral Foot Pain

Islin's Disease DiagramChildren often complain of aches and pain that settle with little more than rest. However, if you child is suffering from acute pain, or general soreness that last more than 5 days it is wise to have this checked out by a Podiatrist.

Children complaining of pain on the outside of the foot may have a condition known as Iselin’s disease or Iselin’s syndrome.

Generally children suffering from Iselin’s syndrome will report pain on the outer edge of the foot, at the prominence known as the styloid process. Some redness and swelling over the area will usually be present. Barefoot activity, jumping sports and narrow fitting footwear can be aggravating factors. Individual biomechanical factors need to be assessed and treated, as splaying of the forefoot associated with flat feet, and walking on the outside of the feet with high arched/inverted feet are associated with Iselin’s disease.

Islin's Disease X-rayIt has been reported rarely, but is probably more common than appreciated. Clinically it can be confused with tendonitis, ankle sprains, fractures of the 5th metatarsal or even labeled as  growing pains. It appears to be more common in athletically active, older children and adolescents, and more common in males. Early recognition and treatment may prevent long-term complications such as non-union and subsequent pain.

Early treatment often consists of conservative measures – rest, ice, padding, footwear, orthotics, stretching, massage of peroneals, etc. Delayed intervention can lead to continued stress through the fusion of the secondary ossification centre and even non-union. Non-union is usually very painful, and may require surgical excision of the proximal epiphysis or open reduction internal fixation with an orthopaedic screw.

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