Bilateral Os Vesalianum Pedis: A Case Report

Background and Objective Os Vesalianum Pedis (OVP) is a rare accessory ossicle located at the base of the fifth metatarsal. It is frequently misdiagnosed as a fracture or an osteochondrosis, leading to unnecessary treatment and considerable patient anxiety. This paper reports a case of bilateral OVP and, in combination with a systematic literature review, discusses the embryological basis, characteristic imaging findings, and key points of differential diagnosis. Methods We describe a patient who presented after trauma and was confirmed by imaging to have bilateral OVP at the base of the fifth metatarsal. A systematic literature search of PubMed and Embase was performed to retrieve and review relevant studies. Results The patient achieved complete pain relief after three months of conservative treatment. The literature indicates that the overall prevalence of OVP is 0.1%–1.0%, that the condition is often bilateral and asymptomatic, that more than 90% of symptomatic patients respond to conservative management, and that surgical intervention is required in only a handful of cases (fewer than 11 cases reported in the literature). Conclusion A higher level of clinical awareness of OVP, supported by careful physical examination and systematic radiological evaluation (including bilateral comparison), is essential to avoid misdiagnosis and prevent overtreatment. Level of Evidence Level Ⅳ,Case Report.