5th metatarsal stress fractures are most commonly seen in good amateur and professional athletes. They usually present with vague lateral foot pain during or after exercise. Sometimes they can present with sudden severe pain when running and suddenly changing direction for example without any direct trauma to the foot. Early diagnosis is important usually with x-ray and MRI. Early diagnosis allows early treatment and immobilisation often avoiding the need for surgery. Chronic 5th metatarsal stress fractures on the other hand often require screw fixation to achieve bony healing.