F is for Frieberg’s Disease

November 15, 2012

Frieberg’s Disease is a osteochondrosis of the head of a metatarsal bone, most commonly the second.

Frieberg's Disease

Frieberg’s disease, also known as Freiberg’s infraction or osteochondrosis of the metatarsal head, is a condition that affects the metatarsal bones in the foot. It is characterized by aseptic necrosis, which is the death of bone tissue due to an interruption of the blood supply. Frieberg’s disease typically affects the second metatarsal bone, although it can affect other metatarsals as well.

Cause: The exact cause of Frieberg’s disease is not fully understood. It is believed to result from a combination of factors, including mechanical stress or trauma to the metatarsal head, abnormal foot mechanics, genetic predisposition, and vascular insufficiency (poor blood supply to the bone).

Symptoms: The primary symptom of Frieberg’s disease is pain in the forefoot, specifically in the area of the affected metatarsal head. The pain is often aggravated by walking or bearing weight on the foot. Swelling and stiffness may also be present. Over time, the affected metatarsal head may become enlarged and develop a callus.

Diagnosis: Diagnosis of Frieberg’s disease is typically made through a combination of clinical evaluation, medical history, and imaging studies. X-rays can help visualize changes in the affected metatarsal bone, such as flattening or collapse of the bone, sclerosis (thickening) of the bone, and the presence of joint space narrowing.

Treatment: The treatment of Frieberg’s disease depends on the severity of the condition and the extent of symptoms. Non-surgical treatment options may include rest, activity modification, pain management (e.g., non-steroidal anti-inflammatory drugs), the use of supportive footwear or orthotics to offload the affected area, and physical therapy to improve foot mechanics and reduce stress on the metatarsal heads. In more severe cases or when conservative measures fail, surgical interventions such as decompression procedures, joint realignment, or joint fusion may be considered.

Prognosis: The prognosis for Frieberg’s disease varies depending on the stage of the condition and the effectiveness of treatment. In the early stages, conservative measures are often successful in managing symptoms and preventing further progression. However, in advanced stages with significant joint damage, long-term complications and persistent pain may occur.


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