Clinical: 39 y/o female with non-traumatic pain for 1 year.
Dx: Avascular necrosis involving the second metatarsal head. This likely originated as a subchondral stress fracture. There is developing, now mild to moderate, second MTP joint arthrosis. There is a moderate joint effusion with synovitis. A similar and perhaps identical pathogenesis to Freiberg’s infraction.
1. Torriani M, Thomas B, Bredella M, Ouellette H. AJR: 2008 – vol. 190, pp. 570-575