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Clinical Case Study

clinical case study

Patient

Female, 24 years old, 125 lbs.

Complaint

Dull, throbbing pain on the lateral plantar aspect of the left foot, just proximal to the fifth metatarsal base.

History

The patient has been a runner for the past five years. She runs 30-40km per week. No previous leg or foot problems.

Clinical Observations

The patient demonstrates a 4 degree subtalar varus and a 3 degree forefoot valgus bilaterally. Palpation of the area just proximal to the fifth metatarsal base elicits acute pain. X-ray findings are negative.

Diagnosis

Cuboid peroneal syndrome

Discussion

Symptoms occur along the lateral aspect of the plantar surface of the foot. The condition must be differentiated from long plantar ligament strain, the difference being that the long plantar ligament strain begins as a slightly painful entity upon arising and becomes worse as the day progresses. Cuboid peroneal syndrome is immediately painful upon arising and constantly throughout the day. The condition is one of tendonitis of the peroneus longus tendon as it passes through the groove on the under surface of the cuboid. The condition is usually seen in a high-arch type foot. Forefoot valgus is commonly present.

Management, acute

Cortisone injections plus lateral type cushion padding from the head of the fifth metatarsal to the anterior aspect of the calcaneus carried across the whole width of the foot. Persistent cases respond well to orthotic therapy.

Management, chronic

Rarely, operative intervention in the form of re-grooving of the peroneal groove on the cuboid and thinning of the peroneal longus tendon is needed.

Sport orthotic
Our Sport orthotic, as all of our devices, are completely customizable. Whatever posting, modifications, additions, or covers your patient needs, we can accommodate.

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