Iselin’s Disease

Iselin’s Disease

What is Iselin's Disease?

Iselin’s disease, also known as apophysitis of the fifth metatarsal base, is a child foot condition that causes pain in the outer foot. It is a type of osteochondrosis that causes pain at the styloid process of the fifth metatarsal – the long bone at the outer foot that connects to the smallest toe. This condition typically affects children and adolescents active in sports like basketball, football, or ballet.

Iselin's disease, osteochondrosis of the fifth metatarsal bone in Singapore

Causes of Iselin's Disease

Iselin’s disease occurs when there is too much traction and stress of the peroneal tendons on the growth plate of the fifth metatarsal. The traction and stress are often due to:

  • Overuse: Repetitive stress from jumping and running when the child is participating in sports
  • Muscle weakness or tightness: Tight calf or weak foot muscles can cause muscular imbalance and further stress the growth plate.
  • Inappropriate footwear: Wearing shoes that don’t provide adequate support or cushioning causes muscles to overwork and adds traction to the growth plate.


Children with Iselin’s disease typically complain of:

  • Pain on the outer foot, specifically around the fifth metatarsal base.
  • Pain after physical activity, particularly in sports that involve jumping or tip-toeing.
  • Redness, swelling and tenderness in the affected area.
  • Difficulty walking after physical activity and the pain can generally last a few days to a week.


We must review the patient’s history and conduct a thorough physical examination to diagnose Iselin’s disease correctly. Your medical professional may also recommend the following tests:

  • X-ray: An X-ray can help detect abnormalities in the growth plate and rule out other possible diagnoses.
  • MRI: Magnetic resonance imaging (MRI) can provide a more detailed view of the affected area and help confirm the diagnosis. However, this is rarely necessary.

Management of Iselin's Disease in Singapore

You must understand that it is unlikely to fully cure Iselin’s disease until the child matures and the growth plate fuses. Therefore, Iselin’s disease treatment will primarily focus on relieving pain and inflammation and addressing the condition’s underlying cause. Proper management allows the child to enjoy their activities with minimal discomfort.

Typical treatment options in Singapore include:

  • Rest: Your child should avoid physical activities that exacerbate pain or discomfort.
  • Ice: Applying ice to the affected area for 10-15 minutes several times daily can help reduce inflammation.
  • Over-the-counter medications: Anti-inflammatory medications can be helpful, but you should check with a medical practitioner before taking them.
  • Physical therapy: Muscular strengthening and stretching can help improve your child’s muscle strength and flexibility.
  • Custom orthotics: Custom insoles can help redistribute pressure on the foot and provide additional support to reduce stress on the growth plate.
  • Proper footwear: Wearing supportive shoes is essential to control foot motions and reduce the stress of the tendon on the growth plate.


Iselin’s disease is a rare and often misdiagnosed children’s foot condition that can impact your child’s ability to participate in daily activities. Understanding the causes, symptoms, and management is essential for detecting the problem early and seeking proper help. If you feel that your child may have Iselin’s disease, it is important to consult a medical professional for an accurate diagnosis and management plan.

Early intervention can help ensure your child continues to enjoy what they like to do and prevent deterioration.

Do You Have A Question? Ask Us...


Other conditions, such as peroneal tendinitis, can mimic the symptoms of Iselin’s disease. Therefore, you cannot conclude that your child has the condition if they have pain on the outer foot. Our best recommendation is to bring your child to a paediatric podiatrist or medical professional for a thorough assessment.

While it is challenging to prevent Iselin’s disease completely, there are several risk factors that you and your child should take note:

  • High-impact activities: Your child should avoid activities that are not suitable for their age to minimise the risk of injuries.
  • Not having sufficient rest after activities: Your child should have enough rest after physical activities so that the body can recover.
  • Wearing one shoe for all: You should keep your child from participating in various activities using the same shoes. Wearing shoes that are suitable for sports can reduce the risk of injuries.
  • Not stretching after activity: Your child should stretch after exercise to prevent muscles from fatiguing and causing injuries.

Iselin’s disease is a condition that affects children’s feet only. This is because the growth plate fuses when we reach skeletal maturity. Therefore adults do not suffer from osteochondrosis.

No, you should not stop your child from participating in physical activities because they support your child’s normal development. The key to managing Iselin’s disease is ensuring your child can still enjoy physical activities with minimal discomfort.

Flat feet and high arch feet alter our gait pattern and can increase the stress of the peroneal tendons on the fifth metatarsal bones. So although there are no studies to suggest this, flat feet and high arch feet may increase the risk of developing Iselin’s disease.