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The patient is a 3-year-old female who presented after a fall while running and complaining of pain over the foot. There was minimal local tenderness over the foot and minimal limp, but no other remarkable findings.

View the x-ray taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.

Clinical Challenge: April, 2007

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services