Findings
Thin section CT and MRI images of 25-year-old female reveals flattening, sclerosis of second metatarsal head with subchondral sclerosis, cysts, fragmentation & small intraarticular loose bodies. Mild degenerative changes of the second metatarsophalangeal joint are seen in the form of osteophytes, articular surface sclerosis and minimal joint effusion.
Diagnosis
Freiberg disease with secondary degenerative changes of the second metatarsophalangeal joint.
Summary
- Freiberg Disease is a painful osteochondrosis involving the metatarsal heads, occurs most often in adolescent girls who perform ballet and dance.
- The exact etiology remains unknown with major contributing factors including repetitive stress and improper shoe wear including high heels.
- This condition occurs bilaterally in less than 10 percent of cases.
- It typically affects the 2nd more than the 3rd metatarsal but has also been described in rare cases to involve the 4th or 5th metatarsals.
- Most early-stage cases of Freiberg disease resolve with symptom regression after conservative therapy in the form of anti-inflammatory medications and activity modification, usually by immobilization of the foot for 4-6 weeks followed by a gradual return to activity with shoe wear modifications.
- Surgery is required in case of faulire of conservative measures to stem the symptoms. Later stages of the disease may also require surgery due to persistent symptoms from arthrosis and loose bodies within the joint.
Further reads
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