Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, localized pain in the left forefoot, specifically localized to the third metatarsal head. Pain is exacerbated by weight-bearing activities and prolonged standing. No history of acute trauma. Symptoms are consistent with osteochondrosis of the third metatarsal head (Freiberg's disease).
Clinical Examination Findings
Physical examination of the left foot reveals localized tenderness upon palpation of the third metatarsal head. Mild edema and restricted range of motion at the third metatarsophalangeal (MTP) joint noted. No signs of erythema or infection. Gait analysis demonstrates antalgic pattern favoring the lateral aspect of the foot to offload the third metatarsal.
Treatment Protocol
Conservative management initiated including offloading of the third metatarsal head via metatarsal pad or custom orthotics. Activity modification to avoid high-impact loading. Non-steroidal anti-inflammatory drugs (NSAIDs) prescribed for pain management. Referral for physical therapy to maintain joint mobility. Follow-up imaging in 6 weeks to monitor progression.