Bilateral Freiberg disease in a young female dancer: A case report

Freiberg's infarction is the disorder of cartilage degeneration. The second metatarsal head is most vulnerable to Freiberg's infarction due to its longer length and relative immobility. It is exposed to repetitive stress even during normal activity. The multifactorial etiology of Freiberg's infarction is mentioned in the literature. It commonly affects the adolescent female with a female-to-male ratio of 5:1. High prevalence in adolescent females is explained in some literature due to wearing high heels, which leads to repetitive forced dorsiflexion injuries to the metatarsal head. Our case is an adolescent female of 20 years who was participating in dancing for 5 months. On examination, there is swelling and tenderness in the bilateral foot, more on the right side. Plain radiography showed the flattening of the head of the right second metatarsal with increased joint space. Mild sclerosis of the underlying bony cortex was seen. A mild deformity with flattening of the lateral surface of the head of the left second metatarsal was also seen.