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Figure 20d.  March fracture (fatigue fracture). (a, b) Frontal radiographs of the right foot in a college gymnast show the early (a) and late (b) radiographic findings of a second metatarsal fatigue fracture (arrow). The fracture completely healed with rest. (c, d) Coronal T2-weighted fat-saturated (c) and sagittal T1-weighted (d) MR images obtained at the same time as a show marked mass effect (arrows) around the second metatarsal. This finding could have been misinterpreted as a neoplasm or infectious process without the radiographs and proper patient history.