Freiberg disease
Updates to Article Attributes
Freiberg disease,also known as Freiberg infraction, is osteochondrosis of metatarsal heads. It typically affects the 2nd metatarsal head (the third and fourth may also be affected). It can be bilateral in up to 10% of cases.
Epidemiology
It is commoner in women aged 10-18 (male to female ratio of 1:3).
Clinical presentation
Clinically they present with pain (sometimes a painful limp), swelling and tenderness.
Pathology
The cause of Freiberg infraction is controversial and is probably multifactorial.
A traumatic insult in the form of either acute or repetitive injury and vascular compromise are the most popular theories, and as it is more commonly seen in women particularly during adolescence, high-heeled shoes have been postulated as a possible causative factor.
Histologically Freiberg infraction is characterised by collapse of the subchondral bone, osteonecrosis, and cartilaginous fissures 1.
Radiographic features
Radiograph
These can be split into early and late features:
Early
- flattening and cystic lesions of the affected metatarsal head
- widening of the metatarsophalangeal (MTP) joint
Late
- osteochondral fragments
- sclerosis and flattening of the bone
- increased cortical thickening
MRI
Early MR imaging findings include low-signal-intensity changes in the metatarsal head on T1-weighted images with increased signal intensity on corresponding T2-weighted and STIR images.
With disease progression, flattening of the metatarsal head occurs, and low-signal-intensity changes develop on T2-weighted images as the bone becomes sclerotic.
History and etymology
It was first described by Albert HAlfred H Freiberg in 1914.
See also
-</ul><h5>MRI</h5><p>Early MR imaging findings include low-signal-intensity changes in the metatarsal head on T1-weighted images with increased signal intensity on corresponding T2-weighted and STIR images.</p><p>With disease progression, flattening of the metatarsal head occurs, and low-signal-intensity changes develop on T2-weighted images as the bone becomes sclerotic.</p><h4>History and etymology</h4><p>It was first described by <strong>Albert H Freiberg</strong> in 1914.</p><h4>See also</h4><ul><li><a href="/articles/avascular-necrosis">avascular necrosis</a></li></ul>- +</ul><h5>MRI</h5><p>Early MR imaging findings include low-signal-intensity changes in the metatarsal head on T1-weighted images with increased signal intensity on corresponding T2-weighted and STIR images.</p><p>With disease progression, flattening of the metatarsal head occurs, and low-signal-intensity changes develop on T2-weighted images as the bone becomes sclerotic.</p><h4>History and etymology</h4><p>It was first described by <strong>Alfred H Freiberg</strong> in 1914.</p><h4>See also</h4><ul><li><a href="/articles/avascular-necrosis">avascular necrosis</a></li></ul>