Freiberg's Disease: Causes, X-Rays & Management

What Is Freiberg's Disease and What Causes It?

Freiberg's disease develops when repetitive stress or trauma causes microfractures near the epiphyseal growth plate of a metatarsal head. This structural damage can impair blood flow to the joint, triggering avascular necrosis where bone cells die from lack of circulation. As bone structural integrity weakens, the joint surface collapses, resulting in localized pain, swelling, and stiffness under the ball of the foot.

How Freiberg's Disease Appears on X-Rays

Radiographic imaging clearly demonstrates the physical changes associated with Freiberg's disease. On X-ray, the second metatarsal head typically shows a shortened, flattened appearance rather than its healthy rounded shape. This altered joint geometry changes how weight is distributed across the forefoot during gait. Using supportive footwear and cushioned orthotic insoles can help redistribute plantar pressure away from the sensitive joint.

Key Characteristics of Freiberg's Disease

• Pain and tenderness concentrated around the ball of the forefoot
• Visible flattening and shortening of the second metatarsal head on X-ray
• Linked to microtrauma or stress during adolescent growth phases
• Avascular necrosis resulting from reduced blood supply to the bone

This article is intended for educational purposes only and should not replace professional medical advice. If you are experiencing persistent forefoot pain or suspect a foot condition, please consult a qualified podiatrist or healthcare professional.