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Freiberg Infraction
Corrie M. Yablon, MD; Julia R. Crim, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Infraction = infarction and fracture
                • Freiberg infraction in adolescents = osteochondrosis of metatarsal (MT) head 
                • In adults: subchondral insufficiency fracture vs. osteonecrosis of MT head 

              IMAGING

              • General Features

                • Radiographic Findings

                  • MR Findings

                    • Imaging Recommendations

                      • Nuclear Medicine Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Lee S et al: Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb. Skeletal Radiol. 48(7):1011-21, 2019
                                        2. Hodes A et al: Metatarsalgia. Radiol Clin North Am. 56(6):877-92, 2018
                                        3. Schade VL: Surgical management of freiberg's infraction: a systematic review. Foot Ankle Spec. 8(6): 498-519, 2015
                                        4. Talusan PG et al: Freiberg's infraction: diagnosis and treatment. Foot Ankle Spec. 7(1):52-6, 2014
                                        5. Shane A et al: Second metatarsophalangeal joint pathology and freiberg disease. Clin Podiatr Med Surg. 30(3):313-25, 2013
                                        6. Carmont MR et al: Current concepts review: Freiberg's disease. Foot Ankle Int. 30(2):167-76, 2009
                                        7. Torriani M et al: MRI of metatarsal head subchondral fractures in patients with forefoot pain. AJR Am J Roentgenol. 190(3):570-5, 2008
                                        8. Nguyen VD et al: Freiberg's disease in diabetes mellitus. Skeletal Radiol. 20(6):425-8, 1991
                                        9. Stanley D et al: Assessment of etiologic factors in the development of Freiberg's disease. J Foot Surg. 29(5):444-7, 1990
                                        10. Young MC et al: Osteochondral disruption of the second metatarsal: a variant of Freiberg's infraction? Foot Ankle. 8(2):103-9, 1987
                                        11. Gauthier G et al: Freiberg's infraction: a subchondral bone fatigue fracture. A new surgical treatment. Clin Orthop Relat Res. (142):93-5, 1979
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Infraction = infarction and fracture
                                                      • Freiberg infraction in adolescents = osteochondrosis of metatarsal (MT) head 
                                                      • In adults: subchondral insufficiency fracture vs. osteonecrosis of MT head 

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            • Nuclear Medicine Findings

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Lee S et al: Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb. Skeletal Radiol. 48(7):1011-21, 2019
                                                                              2. Hodes A et al: Metatarsalgia. Radiol Clin North Am. 56(6):877-92, 2018
                                                                              3. Schade VL: Surgical management of freiberg's infraction: a systematic review. Foot Ankle Spec. 8(6): 498-519, 2015
                                                                              4. Talusan PG et al: Freiberg's infraction: diagnosis and treatment. Foot Ankle Spec. 7(1):52-6, 2014
                                                                              5. Shane A et al: Second metatarsophalangeal joint pathology and freiberg disease. Clin Podiatr Med Surg. 30(3):313-25, 2013
                                                                              6. Carmont MR et al: Current concepts review: Freiberg's disease. Foot Ankle Int. 30(2):167-76, 2009
                                                                              7. Torriani M et al: MRI of metatarsal head subchondral fractures in patients with forefoot pain. AJR Am J Roentgenol. 190(3):570-5, 2008
                                                                              8. Nguyen VD et al: Freiberg's disease in diabetes mellitus. Skeletal Radiol. 20(6):425-8, 1991
                                                                              9. Stanley D et al: Assessment of etiologic factors in the development of Freiberg's disease. J Foot Surg. 29(5):444-7, 1990
                                                                              10. Young MC et al: Osteochondral disruption of the second metatarsal: a variant of Freiberg's infraction? Foot Ankle. 8(2):103-9, 1987
                                                                              11. Gauthier G et al: Freiberg's infraction: a subchondral bone fatigue fracture. A new surgical treatment. Clin Orthop Relat Res. (142):93-5, 1979