Freiberg infraction

Case contributed by Bahman Rasuli
Diagnosis almost certain


Left sided forefoot pain.

Patient Data

Age: 15 years
Gender: Male

MRI examination shows bone marrow edema of the 2nd to 4th metatarsals with evidence of small cortical defect at the level of the second metatarsal head. There is also diffuse edema of the interosseous muscles along with periarticular fluid near to the body and head of the second metatarsal.

Bone marrow edema also is seen at the hindfoot and midfoot bones.

Type 2 accessory navicular with minor bone marrow edema at the synchondrosis is noted.

Case Discussion

Freiberg infraction is osteochondrosis of metatarsal heads. It typically affects the 2nd metatarsal head, although the 3rd and  4th metatarsals may also be affected. It is most common in females aged 10~18 years and can be bilateral in up to 10% of cases.

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