Freiberg’s Disease

Freiberg’s Disease, also known as Freiberg infraction, is a rare, painful condition that affects the metatarsal heads in the foot—most commonly the second metatarsal. It typically arises during adolescence or young adulthood and is considered a form of avascular necrosis, where blood supply to the bone gets compromised. This lack of blood flow leads to the collapse and fragmentation of the bone at the joint surface. Although the exact cause isn’t always clear, repetitive stress (like sports activity), trauma, or genetic predisposition may contribute to the development of the disease.

Clinically, patients with Freiberg’s Disease often present with pain in the forefoot, swelling, limited joint motion, and difficulty bearing weight on the affected foot. These symptoms usually worsen with activity and improve with rest. Over time, if left untreated, the joint surface can deteriorate further, leading to chronic pain and even deformity. Radiographs typically reveal flattening and sclerosis of the metatarsal head, and advanced imaging like MRI can detect early changes by showing bone marrow edema and subchondral collapse before these changes become visible on X-rays.

Treatment options depend on the severity and stage of the disease. In the early stages, conservative management such as rest, activity modification, orthotic support, and anti-inflammatory medications might help reduce symptoms and prevent progression. In more advanced cases, where joint degeneration has occurred, surgical intervention may be necessary—ranging from debridement, osteotomies, to even joint replacement or excision procedures. Prompt diagnosis and individualized treatment are key to preserving joint function and preventing long-term disability..

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