On physical exam there will be pain and swelling. In the case of simple non-displaced fractures, or stress fractures, there is not likely to be foot deformity. In comminuted crush “nutcracker”-type fractures there may also be deformity with shortening of the lateral column.
Plain x-rays will often show the fracture.
CT with sagittal and coronal reconstructions is useful in obtaining a three-dimensional understanding of the injury. CT protocol should be thin cuts with large overlap.
This CT scan shows a comminuted extruded cuboid (arrow).
In the case of continued pain without abnormality on x-rays, a bone scan or MRI might be useful in uncovering a stress fracture.