Freiberg infraction

Case contributed by Dr Derek Smith


Long distance runner. Acute onset of pain when running last night. Difficulty weight-bearing, and tender on palpation of midfoot. ?fracture ?stress fracture

Patient Data

Age: 35 years
Gender: Male

Flattening of the third metatarsal head consistent with early osteochondrosis/Freiberg infraction. Preserved MTPJ. No fragmentation.

No acute fracture.

Case Discussion

This appearance is an important review area, especially with forefoot pain. Osteochondrosis (a.k.a. Freiberg infraction/disease) can typically affect the head of the second metatarsal, although the third and fourth have also been recognized as being affected.

No definitive etiology has been established, although in this case the repetitive trauma from long distance runner will have contributed. It is unclead what led to this acute presentation, given the relatively chronic appearance of the bone change.

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Case information

rID: 60885
Published: 6th Jun 2018
Last edited: 6th May 2020
Inclusion in quiz mode: Included

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