FREIBERG DISEASE
Freiberg disease is a painful condition of the forefoot occurring most often in adolescent girls who participate in ballet and dance.23 The exact etiology is unknown, but it is commonly characterized by disordered ossification of the second metatarsal head. Possible causes include trauma, repetitive stress, disruption in blood supply, or improper shoe wear.24,25 Bilateral involvement occurs in less than 10 percent of patients.25 Pain is exacerbated by weight-bearing and athletic activities. Point tenderness and swelling are commonly found over the affected metatarsal head. Plain radiographs show sclerosis and varying degrees of flattening of the affected articular surface. In most patients, nonoperative treatment consisting of activity modification, metatarsal pads, and well-padded shoes facilitates regeneration of the metatarsal head and spontaneous resolution of symptoms.26