īone remodels in response to a focal point of mechanical stress. This diagnosis is made in a symptomatic patient who has a bone scan or MRI evidence of bone periosteal reactive changes without a true fracture line. Many factors influence the risk of stress fractures, these being divided into intrinsic (gender, age, race), extrinsic (training regimen, footwear, surface, sport), biomechanics (bone geometry), hormonal (menses abnormalities, contraception, thyroid) and nutritional (eating disorders). Taken individually, the single loading does not lead to a failure of the bone cortex. However, the amalgamation of the individual loading stresses can lead to mechanical failure of the bone, leading to a stress fracture. The initial stage of bone failure is generally called a stress reaction. These stresses, in particular for cuboid stress fractures, can be increased when there is overloading of the lateral column due to structural abnormalities or deficits in supportive soft tissue structures, such as weakening or rupturing the plantar fascia. The thinking regarding the underlying etiology of stress injuries to the bone is that they are the result of repeated mechanical stress, which can be either compressive or tensile. Increased levels of fitness activities in today's population and advanced imaging technologies have caused a rise in reported cases of stress fractures, which now make up 10% of cases in a typical sports medicine practice. This triad has been shown to increase the risk of stress fractures by 30 to 50%. Furthermore, a specific triad has been associated with the female athlete involving amenorrhea, low bone mineral density, and dietary restraint. General risk factors for stress fractures include running, jumping, marching, decreased bone density, female gender, and poor pre-activity conditioning. Stress fractures are within a spectrum of overuse injuries to the bone caused by changes in training regimens in professional athletes, highly competitive recreational athletes, and military recruits. This condition should be a consideration in a patient with continual lateral foot or ankle pain, especially if the patient has persistent lateral foot pain, is athletically inclined, and has a history of repetitive use such as running, triathlon, and jumping activities such as ballet. Isolated stress fractures of the cuboid are rare, with a review of literature showing less than a 1% incidence. Due to the repetitive mechanical forces dissipated in the area, the foot is prone to overuse injuries, especially stress fractures. The cuboid bone is on the most lateral aspect of the mid-foot, articulating with the calcaneus proximally and the base of the fourth and fifth metatarsals distally. This area comprises the navicular medially, three cuneiform bones, and the cuboid on the lateral side. The cuboid bone is within the area of the mid-foot. The foot is anatomically subdivided into the hindfoot, midfoot, and forefoot. The foot is comprised of 26 bones and 33 joints. Foot conditions can be challenging to diagnose and treat due to their complex anatomy.
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