Freiberg infraction case presentation A healthy, 21-year-old man presented with a 1-year history of persistent right mid to forefoot pain.
Freiberg infraction case presentation A healthy, 21-year-old man presented with a 1-year history of persistent right mid to forefoot pain. His pain was worse with activity. Swelling, tenderness and restricted motion of the second metatarsophalangeal (MTP) joint were evident, especially during dorsiflexion; a positive Lachman test suggested MTP joint instability.
A right foot X-ray showed that one of his metatarsal heads was flattened and sclerotic and had joint surface irregularity. Which of the following is the most likely diagnosis metatarsal involved? Kohler’s disease, navicular B.
Kohler’s disease, second metatarsal C. Freiberg infraction, second metatarsal D. Freiberg infraction, cuboid introduction Freiberg infraction, or Freiberg’s disease, is an osteonecrosis of the metatarsal head bone, which was firstly described in 1914.
It was initially named “infraction” because of the initial association with minor trauma to the foot. Freiberg disease most often affects the second MTP joints and is less frequently observed at the third, fourth, and fifth MTP joints. Sports medicine providers must be aware of this condition and it should be in the differential with individuals with midfoot pain.
Freiberg infraction pattern results in flattening and collapse of the head of the second metatarsophalangeal joint, leading to degenerative changes and progressing to arthritis. It is the fourth most common form of primary osteochondrosis with a significant predilection to the adolescent athletic female population, although it has been seen over a wide age range. It is generally accepted that the condition is of multifactorial cause, including trauma, foot mechanics, and arterial insufficiency.
If you are experiencing symptoms that may be related to freiberg infraction, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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