• painful condition of forefoot

• adolescent girls >12yo

• ballet/dance

• eitology unknown

• commonly characterized by disordered ossification of second metatarsal head

• possible causes:

• trauma

• repetitive stress

• disruption in blood supply

• improper shoe wear

• Bilateral involvement occurs in \<10%

• exacerbated by weight-beraring and athletic activities

Examination

• point tenderness and swelling commonly found over affected MT head

• Plain XR show :

• sclerosis

• flattening of affected articular surface

• MRI/radioisotopic bone scan and MRI are more sensitive Ix

Treatment

• activity modification

• MT pads

• well padded shoes -> regeneration of MT head and spont. resolution of symptoms

• Surgical intervention if not settling