What's the most likely diagnosis?
- 18 year-old female with pain in foot
- Osteoarthritis
- Gout
- Freiberg's infraction
- Hallux valgus
- Hammer toes
Answer:
3. Freiberg's infraction
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Freiberg's Infraction
General considerations
- Named “infraction” because it was originally thought secondary to trauma
- Exact cause remains uncertain but thought to be one of the osteochondroses in adolescents
- Osteochondroses are diseases that usually affect the epiphyses of growing bones resulting in necrosis most likely on a vascular basis, although the exact mechanism is not known
- In others, Freiberg's may be due to a combination of trauma, and vascular insults
- Relatively uncommon
- Painful collapse of the head of the 2nd metatarsal
- May affect 3rd metatarsal head as well
- Women to men by 5:1
- Possibly because of shoes, i.e. stresses placed on toe by high-heeled shoes
- Length of second metatarsal thought to be a factor by some
- Usually adolescents
- Almost always unilateral
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