The patient is a 2-year-old girl who experienced a blow to the left foot when she jumped from an unspecified height while playing. The parents were unaware at the time the injury occurred, but toward evening the girl refused to apply weight to her left foot.

On exam, the foot is mildly swollen and tender. Otherwise, there are no remarkable findings. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be.


Resolution of the case is described on the next page.

Clinical Challenge: July 2008

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services
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