Presentation
Young female with painful swelling and stiffness at the level of the second metatarsophalangeal joint since 2 months. No history of trauma.
Patient Data
MR demonstrates distal flattening of the articular surface with bone marrow edema and there is also a loss of the normal marrow signal throughout the head and shaft of the 2nd metatarsal bone. A reactive joint effusion at the 2nd metatarsophalangeal joint and mild periarticular soft tissue enhancement after contrast administration are also present.
CT at the same level reveals the head of the second metatarsal bone is flattened with cortical irregularity, subcortical fracture and mixed subarticular resorption with sclerosis.
Findings are suggestive of Freiberg’s disease.
Case Discussion
The case illustrates typical findings of the osteochondrosis of the metatarsal head. Freiberg disease is painful osteochondrosis involving the metatarsal heads. This condition occurs most often in adolescent girls who perform sports activities.