Condition Articles-Freibergs Disease PDF

Freibergs Disease PDF
Pdf Summary
Freiberg's disease is a little-understood disorder that affects the second metatarsal head, resulting in the loss of its structural integrity and leading to pain in the second metatarsophalangeal joint. The exact cause of this condition is unknown, but it is believed to involve a decrease or cutoff in the blood supply to the affected area. Freiberg's disease is more common in adults and is part of a group of disorders called osteochondroses. The second metatarsal head is the most commonly affected area, followed by the third and fourth metatarsal heads. Bilateral involvement occurs in about 10% of cases. <br /><br />There are five stages in the progression of Freiberg's disease. Stage one involves a loss of blood flow to the affected bone, while stage two is the collapse of the subchondral bone. Stage three is further collapse, with some bone absorption, stage four involves some fracture of the plantar hinge, and stage five is characterized by MTP arthrosis. <br /><br />Patients with Freiberg's disease often experience pain and stiffness in the affected area, with pain worsened by weight-bearing activities. Physical exam reveals swelling and tenderness in the affected metatarsophalangeal joint, and sometimes a callus underneath the metatarsal head. <br /><br />Radiographic changes in the early stages of the disease may be subtle, with joint space widening being the earliest indication. Late stages show arthritic joint features such as joint space narrowing, osteophytes, periarticular sclerosis, and loose bodies. Magnetic resonance imaging can reveal periarticular edema and collapse of the articular surface.<br /><br />Treatment options for Freiberg's disease include non-operative measures such as casting, non-weight-bearing, orthotic inserts, and stretching exercises. Surgical treatment may be necessary for advanced cases, which can involve core decompression, joint debridement, metatarsal osteotomies, or metatarsal head excision with or without interposition arthroplasty. Early diagnosis and treatment are important to alleviate symptoms and prevent the progression of the disease.
Keywords
Freiberg's disease
second metatarsal head
structural integrity
pain
metatarsophalangeal joint
osteochondroses
blood supply
stages
MTP arthrosis
treatment options