Свежего ничего нет. Такие костной плотности фрагменты в мягких тканях  по наружной поверхности стопы часто встречаются, может как последствие твавмы, а может другая этиология их возникновения. Но это несвежие отломки. А при свежей травме они могут беспокоить пациента.

 Согласен с Ольгой 

 Может быть обызвествления в подошв. апоневрозе, встречал там косточки сесамовидного типа...

Это дополнительная косточка Os Peroneum. И судя по клинке и полученным изображениям, она сломана.

Accessory Bones

Accessory bones are extra bones that are simply variations from 'normal'. They usually originate from secondary centres of ossification that do not unite with the main centres. They tend to be hereditary. It is important that they be differentiated from fractures, most commonly by bilateral presentation and by a smooth rounded border.

Os Naviculare/Os Tibiale Externum - Presents medial to the navicular tuberosity; it is a sesamoid that lies within the tibialis posterior tendon	Os Naviculare/Os Tibiale Externum - another example.
Os Peroneum - a sesamoid which lies within the tendon of peroneus longus/brevis; it articulates with the plantar lateral aspect of the cuboid	Os Trigonum - presents on the posterior aspect of the talus and occurs when the lateral tubercle is separate to the body of the talus; can become enlarged and is known as 'Steida's process'. It is often hard to distinguish from a fracture of the posterior lateral tubercle of the talus.
Os Intermetatarseum - a very common ossicle found at any or all of the lateral metatarsal heads. However, this generally refers to a sesamoid (atavistic metatarsal) between the first and second metatarsals proximally. The site on radiograph has also been described as os intermetatseum, but this should not be misinterpreted as the above, which is the classic description.	Os Interphalangeum of Hallux - sesamoid within the Flexor Hallucis Longus tendon located below the inter-phalangeal joint of the hallux
NOTE: Accessory bones can be located at various other sites including the medial and lateral malleoli and the base of the fifth metatatarsal.

Accessory Bones of the Foot

- most common accessory bones

os trigonum:

    - os tibiale externum (accessory navicular)

    - os peroneum (lateral aspect of cuboid)

    - os vesalianum (base of 5th metatarsal)

- less common accessory bones:

    - os supratalare (antero-supero aspect of talus)

    - os supranaviculare (superior aspect of navicular - seen on lateral)

    - processus uncinatus (at intersection of navicula, 2nd and 3rd cuniform)

    - os intercuneiforme (between the 1st and 2nd cuniforms)

    - pars peronea metatarsalia (1st cuniform and 1st metatarsal)

    - cuboides secundarium (proximal-medial aspect of cuboid)

    - os talotibiale (anterior tibia)

    - os subcalcis (inferior aspect of calcaneus)

    - os sustentaculum

    - os intermetatarseum (between the 1st and second metatarsal)

    - os subfibulare:

          - historically, this has been considered to be an accessory ossicle located just below the ditsal fibular epiphysis;

                - it is distinguished from a fracture by its smooth borders, and by the fact

                        that a fracture will preferentially involve the physis;

          - there is some recent evidence to suggest that this structure may represent a nonunion of an avulsion frx from the fibula;

                - these patients may demonstrate ipsilateral ankle instability and absence of a similar

                        ossicle on the contra-lateral side of the foot;

          - reference:

                  The symptomatic os subfibulare:   Avulsion fracture of the fibula associated with recurrent instability of the ankle.

                      EE Berg. JBJS. Vol 73-A. 1991. p 1251-1254.

- Work Up of Suspected Painful Accessory Bone:

    -

bone scan

:

          - increased uptake on bone scan indicates that the lesion is probably symptomatic;

    - CT scan:

          - helps work up unusual accessory bones and the anatomical imaging will help explain how

                  they are causing symptoms;

Is It a Fracture or Is It an Accessory Ossicle?

By Deborah Pate, DC, DACBR

Accessory ossicles in the foot are abundant, making it difficult to assess whether or not there is a fracture.

1. os talotibiale
2. os supratalare
3. an avulsion, not an accessory bone
4. os supranaviculare
5. os infranaviculare
6. os intercuneiforme
7. os cuneometatarsale II dorsale (also os cuneometatarsale dorsale fibulare)
8. os intermetatarsale
9. os unci? Coalescing with the fourth metatarsal bone?
10. accessory skeletal element distal to the cuboid (wandering os unci?)
11. secondary cuboid (cuboides secundarium)
12. calcaneus secundarius
13. os tibiale externum
14. trigonum
15. os accessorium supracalcaneum
16. posterior calcaneal spur, not an accessory bone
17. os subcalcis
18. inferior calcaneal spur, not an assessory bone
19. bursitis, not an accessory bone
20. peroneal bone (os peroneum)
21. os vesalianum

 Сломать сесамовидную - это надо ухитриться. Тоже написала как-то, травматологи очень повеселились. Скорее всего здесь две добавочные косточки. А боль продиктована повреждением сухожилий и связок.