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INJURIES Middle of Foot Injuries

Diagnosis of Cuboid Fractures- What Tests Are Needed?

Diagnosing cuboid fractures can be difficult. This is because many of the symptoms that people experience after undergoing a cuboid fracture can be similar to other midfoot fractures in the foot. It’s important to accurately diagnose a cuboid fracture. This will ensure that the fracture will be treated appropriately and thus will ensure a faster recovery. 

If you have a cuboid fracture, you may experience pain with swelling on the lateral aspect (outside) of your midfoot. Cuboid fracture symptoms can sometimes vary, so it’s best to see your local foot doctor if you have persisting lateral foot pain. 

Your doctor will evaluate the fracture site by pressing on the cuboid bone to see if there is pain. If your doctor suspects a cuboid stress fracture, he/she will place a vibrating tuning fork over the fracture to see if this causes pain. If it does, there is a chance that a stress fracture may be present. 

What Is a Cuboid Fracture Test?

A cuboid fracture test is a physical test used to assess the stability of the cuboid bone, which is located in the foot. It is performed by pressing on the cuboid bone while the foot is in an abducted position. If the bone is unstable, the person will feel pain, indicating a possible fracture.

doctor discussing persons foot xray

Radiographs for Broken Cuboid Bones

Your doctor will order x-rays to evaluate whether the cuboid bone is fractured. Standard foot x-ray views can be done at your doctor’s office and can identify the presence of a cuboid fracture. 

Your doctor will also check to see whether the fracture is intra-articular (extending into the joint) or extra-articular (fracture that does not extend into the joint).

Your doctor will also be checking to see if the cuboid fracture is displaced (bone fragments have shifted out of alignment) or non-displaced (bone fragments have not shifted). 

Your doctor will then check to see if the cuboid is in its proper alignment. Some cuboid fractures are displaced and do not align with the joints that they articulate with. 

Fracture displacement, fracture angulation, and alignment at the joint space are important factors to look at to determine if surgery may be needed. 

CT Scan for Cuboid Fractures

A Computed Tomography scan (CT scan) may be ordered to evaluate the cuboid fracture. CT scans are helpful because they provide details about the type of cuboid fracture, and the size of the fracture fragments, and can also identify any adjacent fractures. CT scans are very helpful for surgical planning. 

MRI for Cuboid Fractures

A Magnetic resonance imaging test (MRI test) may be ordered to diagnose cuboid fractures. An MRI provides detailed images of the bone and soft tissue structures in the foot. The MRI can help identify a cuboid fracture, as well as any tendon/ligament injury that may be present. Not only that, an MRI can identify nearby fractures as well. 

Ultrasound Imaging for Cuboid Fractures

Occasionally, an Ultrasound may be ordered to diagnose a cuboid fracture. If x-rays don’t identify a fracture, your doctor may order an ultrasound. It is non-invasive and cost-effective when compared to an MRI or CT scan. Sound waves are sent to the cuboid bone and these echoes are then covered in an image on the screen. It can help identify the presence of a fracture. 

Bone Scan for Broken Cuboid

Bone scans (scintigraphy scans) can help identify cuboid fractures. If the x-ray doesn’t identify a cuboid fracture, your doctor may choose to order a bone scan to identify the fracture. 

During the scan, a small amount of radioactive material is injected into the bloodstream. This material then accumulates at the fracture site and can help identify the fracture.  

Conclusion

In conclusion, a combination of physical examination and imaging is necessary to properly diagnose a cuboid fracture. Once the diagnosis is confirmed, treatment of the cuboid fracture can begin. 

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References

  1. Angoules AG, Angoules NA, Georgoudis M, Kapetanakis S. Update on diagnosis and management of cuboid fractures. World J Orthop. 2019 Feb 18;10(2):71-80. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379735/
  2. Pountos I, Panteli M, Giannoudis PV. Cuboid Injuries. Indian J Orthop. 2018 May-Jun;52(3):297-303. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961267/

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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