Stress ("march") Fracture, 3rd Metatarsal

The only radiographic abnormality detected is subtle periosteal reaction in the diaphysis of the 3rd left metatarsal.
No bone destruction is evident.
No fracture is seen.

Radiographic findings in a patient with clinical history of "being on his feet a lot" suggest stress fracture of the 3rd metatarsal.

You may wish to review some facts regarding this entity:

Typical patient is one with new, increased and/or unusual stress.
The result of normal bone subjected to repetitive stress.
Most, but not all, stress fractures involve the lower extremity.
- Jumping, ballet, sports, marching, etc. common precipitating events.
Common sites:
- calcaneus -- jumping
- tibia/fibula -- running
- patella -- hurdling
- pelvis, obturator ring -- gymnastics
- ribs -- heavy lifting, coughing
- vertebrae, pars interarticularis -- lifting
- clavicle -- post-op radical neck dissection
- scapula, coracoid -- trap shooting
- humerus. ulna -- throwing baseball, pitching
- hamate -- golf, baseball

Ref: Resnick, D., Bone and Joint Imaging, W.B. Saunders, Philadelphia, PA, 1989, pp. 808-815.