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Diseases

Genetic and Rare Diseases Information Center (GARD)

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Freiberg's disease


Other Names for this Disease
  • Freiberg's infraction
  • Freiberg-Kohler syndrome
  • Kohler's second disease
  • Osteochondrosis of the metatarsal head, usually the second
  • Second metatarsal osteochondrosis
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Your Question

My son has been diagnosed with Freiberg's disease. Is this condition easy to diagnose? Can an individual with this condition continue to play sports and participate in physical activities? How is it treated?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

How is Freiberg's disease diagnosed?

A diagnosis of Freiberg's disease is often suspected based on the presence of characteristic signs and symptoms. An X-ray, magnetic resonance imaging (MRI), and/or bone scan can then be ordered to confirm the diagnosis. Other testing such as laboratory studies may also be recommended to rule out other conditions that cause similar features.[1][2]
Last updated: 5/14/2015

How might Freiberg's disease be treated?

The treatment of Freiberg's disease depends on many factors, including the severity of condition; the signs and symptoms present; and the age of the patient. The primary goal of therapy is to rest the joint and reduce pain and swelling. A more conservative treatment approach is typically attempted initially which may include modification of activities with different types of casts, crutches and/or shoe inserts, as needed. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to manage pain.[1][3][2]

If other treatments are not effective, surgery may be necessary. Medscape Reference's Web site offers more specific information regarding the different surgical procedures used to treat Freiberg's disease. Please click on the link to access the resource.
Last updated: 5/14/2015

Can a young athlete with Freiberg's disease return to sports?

Although specific times depend upon the person and his/her resolution of symptoms, the following general guide may assist you in determining the appropriate time needed before resumption of activities. The young athlete treated conservatively can usually resume athletic activity after resolution of symptoms. If surgical removal of a loose body is required in older athletes, return to full competition may be possible in 4 to 6 weeks. After joint debridement and remodeling of the metatarsal head, competitive activity may be allowed after 8 to 12 weeks. If arthroplasty or osteotomy is performed, resumption of activity may not be possible for 12 weeks or longer.[4]

We recommend that you speak with your healthcare provider for more specific information about your personal care.
Last updated: 5/14/2015

References
  • Shayne D Fehr, MD, FAAP. Freiberg Disease. Medscape Reference. March 2015; http://emedicine.medscape.com/article/1236085-overview.
  • Cerrato RA. Freiberg's disease. Foot Ankle Clin. December 2011; 16(4):647-658.
  • Shane A, Reeves C, Wobst G, Thurston P. Second metatarsophalangeal joint pathology and freiberg disease. Clin Podiatr Med Surg. July 2013; 30(3):313-325.
  • DeeLee JC, Drez D. Freiberg's Disease. DeeLee and Drez's Orthopaedic Sports Medicine, 2nd ed.. Philadelphia, PA: Saunders, An Imprint of Elsevier; 2003;
Other Names for this Disease
  • Freiberg's infraction
  • Freiberg-Kohler syndrome
  • Kohler's second disease
  • Osteochondrosis of the metatarsal head, usually the second
  • Second metatarsal osteochondrosis
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.