Freiberg disease is an osteochondrosis of the metatarsal heads. It most commonly affects the 2nd metatarsal head, although the other metatarsal such as the 3rd and 4th may also be affected. This condition mainly affects females between the ages of 10-18 years with a male to female ratio of 1:3.
Clinically these patients present with pain on weight-bearing with swelling and tenderness.
The cause of Freiberg infraction is controversial and is probably due to several factors.
The two most popular theories re from trauma and vascular compromise. Trauma can be associated with either acute injury or something that is repetitive in nature, such as dance. Vascular compromise can be due to an elongated 2nd metatarsal. Since this is mainly seen in women, particularly during adolescence, high-heeled shoes have been theorized as a possible causative factor.