Iselin’s disease is a condition that affects the foot, particularly in children and adolescents, and is characterized by pain and inflammation at the base of the fifth metatarsal. This area is located on the outer side of the foot, where the little toe is found. Iselin’s disease is often seen in young athletes who participate in sports that put a lot of stress on the feet, making it important to understand its causes, symptoms, and treatment options to support those affected.
The main cause of Iselin’s disease is repetitive stress and traction forces on the growth plate at the base of the fifth metatarsal. Young athletes, who may be engaged in activities that involve running, jumping, or quick lateral movements, are particularly susceptible to this condition. According to Forrester et al. (2017) and Dharmshaktu et al. (2023), these repeated stresses can lead to inflammation and microtears in the bone, which in turn causes pain and discomfort. This is especially true for growing children, whose bones are still developing and may be more vulnerable to such injuries.
Symptoms of Iselin’s disease typically include pain on the outer side of the foot, especially during activity. This pain may be accompanied by swelling, which can make it uncomfortable for young athletes to participate fully in their sports. Kishan et al. (2016) and Mathieu et al. (2019) noted that children and teens who are very active are more likely to experience these symptoms, as increased physical demands lead to greater stress on their feet. The pain often worsens with increased activity and may improve with rest. As a result, affected individuals may find themselves taking breaks from sports and physical activities, which can impact their performance and fitness levels.
To diagnose Iselin’s disease, healthcare providers start with a physical examination to assess the location of the pain and any visible signs of swelling or tenderness. In many cases, imaging techniques are also used to confirm the diagnosis. One effective method is ultrasonography, which allows doctors to see inflammation around the growth plate and assess the condition of the bone (Liu et al., 2024). X-rays may also be performed, but they can sometimes miss the early signs of Iselin’s disease since changes in bone structure may not appear until later in the progression of the condition.
It is essential to diagnose Iselin’s disease early to manage symptoms and prevent further complications. If left untreated, the ongoing stress and inflammation can lead to more significant injuries or chronic pain, further affecting an individual’s mobility and overall quality of life. Understanding the causes and symptoms of Iselin’s disease can help parents, coaches, and young athletes recognize its onset and seek appropriate care, allowing them to return to their activities safely and effectively., Treatment options for Iselin’s disease often start with conservative measures. These include rest, which is crucial for allowing the affected foot to heal. Patients are encouraged to avoid activities that could increase pain or stress on the foot. Applying ice to the area can help reduce inflammation and swelling. Over-the-counter anti-inflammatory medications, such as ibuprofen, may also assist in managing pain and decreasing inflammation (Sylvester and Hennrikus, 2015). These initial treatments are typically effective for many individuals, especially when they are young and their bodies can recover quicker.
If conservative measures do not provide sufficient relief, physical therapy is often recommended. Physical therapists work with patients on specific exercises designed to strengthen the muscles around the foot. This can help improve flexibility and stability, ultimately reducing pain (Parida et al., 2025). Therapy may also include special techniques to stretch the muscles and tendons, which can alleviate discomfort and support the healing process. For some children and adolescents, the use of custom orthotics or supportive footwear may also be part of the treatment plan to offer added support and comfort while walking or participating in sports.
Iselin’s disease can significantly impact mobility and quality of life, particularly for children and adolescents. Many young people find it difficult to engage in regular physical activities or sports due to the pain associated with this condition. For a child, being unable to play with friends or participate in school sports can lead to feelings of frustration and sadness. The limitations imposed by Iselin’s disease can result in social isolation and a decrease in self-esteem, affecting a young person’s emotional well-being (Aljabri et al., 2023). In some cases, ongoing pain may also hinder a child’s enthusiasm for physical play. This can present a barrier to physical fitness and lead to a more sedentary lifestyle.
As children grow, continued pain or mobility issues can have a lasting impact on their overall quality of life. Struggling to keep up with peers or feeling excluded from fun activities can lead to feelings of anxiety and depression. This psychological stress can further complicate their recovery and overall outlook on health and activity levels (Ballinger, 2024).
Early recognition of Iselin’s disease is vital for effective management. By addressing the symptoms promptly and correctly, health professionals can help individuals avoid the complications that may arise from prolonged discomfort and reduced activity. Providing the right treatment at the right time can minimize the long-term impacts on mobility and encourage a more active, fulfilling lifestyle. Families and caregivers play an essential role in noticing changes in a child’s behavior and comfort levels to seek help early on and facilitate access to appropriate care (Fennell and Onel, 2022).
Citations:
Forrester, R.A., Eyre-Brook, A.I. and Mannan, K., 2017. Iselin’s disease: a systematic review. The Journal of Foot and Ankle Surgery, 56(5), pp.1065-1069. https://www.sciencedirect.com/science/article/pii/S1067251617302818
Liu, L., Wang, T. and Qi, H., 2024. Foot pain in children and adolescents: a problem-based approach in musculoskeletal ultrasonography. Ultrasonography, 43(3), pp.193-208. https://synapse.koreamed.org/articles/1516091387
Dharmshaktu, G.S., Dharmshaktu, I.S., Agarwal, S.K. and Kamat, A., 2023. Iselin’s disease as an uncommon cause of foot pain. MRIMS Journal of Health Sciences, 11(4), pp.283-286. https://journals.lww.com/mjhs/fulltext/2023/11040/iselin_s_disease_as_an_uncommon_cause_of_foot_pain.11.aspx
Mathieu, T., Verspeelt, P., Naessens, G. and Stassijns, G., 2019. Iselin’s disease: case study and literature review. JOURNAL OF SPORTS MEDICINE & DOPING STUDIES, 9(1), p.1000214. https://repository.uantwerpen.be/link/irua/166438
Sylvester, J.E. and Hennrikus, W.L., 2015. Treatment outcomes of adolescents with Iselin’s apophysitis. Journal of Pediatric Orthopaedics B, 24(4), pp.362-365. https://journals.lww.com/jpo-b/FullText/2015/07000/Treatment_outcomes_of_adolescents_with_Iselin_s.17.aspx
Parida, L., Panda, A.K. and Sahoo, B., 2025. Iselin’s disease. Pediatrics & Neonatology, 66(3), pp.287-288. https://www.pediatr-neonatol.com/article/S1875-9572(24)00230-4/fulltext
Kishan, T.V., Mekala, A., Bonala, N. and Pavani, B.S., 2016. Iselin’s disease: Traction apophysitis of the fifth metatarsal base, a rare cause of lateral foot pain. medical journal armed forces india, 72(3), pp.299-301. https://www.sciencedirect.com/science/article/pii/S0377123715000945
Aljabri, N.K., Alhassani, T.H., Labban, A.A., Alsawaf, A.H., Alnofeay, K.A., Aljabri, N. and Alsawaf, A., 2023. Iselin Disease With a Rare Presentation in an Elderly Patient: A Case Report. Cureus, 15(1). https://www.cureus.com/articles/131759-iselin-disease-with-a-rare-presentation-in-an-elderly-patient-a-case-report.pdf
Ballinger, K., 2024. Physeal Stress Injuries of the Ankle and Foot. Physeal Stress Injuries in Young Athletes: Diagnosis, Treatment and Prevention, pp.213-229. https://link.springer.com/chapter/10.1007/978-3-031-70455-0_11
Fennell, J. and Onel, K., 2022. Chilblains-like lesions in pediatric patients: a review of their epidemiology, etiology, outcomes, and treatment. Frontiers in Pediatrics, 10, p.904616. https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.904616/full
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