A common complain by children is pain on the side of the foot. This is often associated with swelling in the area and a concern by the child's parents. The swelling occurs in the middle of the outside portion of the foot. This area is called the ‘styloid process' of the fifth metatarsal. This area represents a growth plate of the fifth metatarsal bone. Attached to this bone is a very powerful tendon called the Peroneus brevis tendon. This tendon originates from a muscle on the side of the lower leg called the Peroneus brevis muscle. This muscle and tendon support the outer ankle and foot. When there is excessive stress on this tendon it will pull excessively on the styloid process and growth plate. This causes swelling and eventually pain in the area.
The diagnosis of this condition requires evaluation of the affected area. An x-ray will reveal an open growth plate. Quite often excessive tightness of the calf muscles can be demonstrated.
In mild cases treatment may consist of rest and cessation of sporting activity. This is generally a temporary measure. In acute presentations rest and an ankle high removable cast may be necessary. Long-term treatment is the use of inserts called orthotics. Orthotics work by correcting the underlying foot function problem that causes this condition. For more information consult your podiatrist.