Bilateral symptomatic os vesalianum pedis: a case report.

Os vesalianum pedis is an uncommon accessory bone. It is located proximal to the fifth metatarsal and found within the peroneus brevis tendon. The incidence is very low, and as with other accessory bones of the foot, it is rarely symptomatic. When symptomatic, the main objective in diagnosis is to differentiate from an ossifying apophysis of the fifth metatarsal base, an apophysitis of the fifth metatarsal base (Iselin's disease), a fracture of the tuberosity of the fifth metatarsal, nonunion of a tuberosity fracture of the fifth metatarsal, an ununited apophysis of the fifth metatarsal base, and an os perineum. We present a very rare case of a bilateral symptomatic os vesalianum pedis. The clinical presentation and course are described, as well as its treatment. This case showed that both conservative and operative treatment can be effective for pain reduction. Operative treatment of course has the risk of complications, a lesion of a branch of the sural nerve occurring in this case. On the other hand, conservative treatment can take a long time to reduce pain, and there is always the risk of recurrence.