Cuboid subluxation in ballet dancers

Cuboid subluxation is a common but poorly recognized condition. Its symptoms include lateral midfoot pain and an inability to 'work through the foot.' In addition, pressing on the plantar surface of the cuboid in a dorsal direction produces pain. The normal dorsal/plantar joint play is reduced or absent when compared to the uninjured side, and subtle forefoot valgus is present. Frequently, there is a shallow depression on the dorsal surface of the foot and palpable fullness on the plantar aspect of the cuboid. Documentation by radiograph, CT scan, or magnetic resonance imaging is difficult because of the normal variations found in the relationship between the cuboid and its surrounding structures. The diagnosis is primarily subjective, and must be made on the basis of the patient's history and physical findings. Treatment requires recognition of the condition, manual reduction by a therapist or physician familiar with the condition, and followup to be certain that the cuboid remains in place. Therapists and orthopaedists involved in the care of dancers should be alert to the possibility of cuboid subluxation and be able to recognize it when it occurs.