The differential diagnosis of metatarsalgia
Objective: to determine the frequency and significance of metatarsalgia diagnostic criteria, to clarify the diagnosis of pain in the forefoot. Methods: we included 190 patients (234 cases) in the study with a pain in the forefoot during the initial treatment, of which 27 were men and 163 women; the average age of patients was (53.2 ± 3.3) years. We assessed the foot pain and its localization, examined sensitivity disorders, anamnesis of overload, the influence of shoes, the presence of corns and hammer toe, sex, «compression» symptoms, anamnesis of overweight. A specific study included the recording of clinical-radiological,
sonographic, and MRI imaging for the elimination of the Morton's neuroma, Freiberg’s disease, intermetatarsal bursitis, and stress fractures of metatarsals. The results were
transferred to the spreadsheets, descriptive statistics were calculated. Results: the analysis of the results showed the presence of metatarsalgia in 107 patients (145 cases), other pathologies were distributed as follows: Morton’s neuroma — 27 patients (28 cases), intermetatarsal bursitis — 11 patients (11 cases), stress fractures of metatarsals — 24 patients (29 cases), Freiberg’s disease — 21 patients (21 cases). Typical clinical signs
of metatarsalgia were: pain under the head of the corresponding metatarsal bone, associated with the load; corns localized in the projection of the heads of the interested metatarsal bones; hammer toe. Predisposing factors were overloading, change in body weight and usage of «wrong» s hoes. X-ray i s a violation of the metatarsal parabola. Conclusions: metatarsalgia is a pathological condition, manifested by pain and corns under
the heads of the corresponding metatarsal bones, the possible development of a fixed hammer toe, significantly worsens the quality of life. Differential diagnosis of pain in the forefoot includes Morton’s neuroma, intermetatarsal bursitis, stress fractures of metatarsals, Freiberg’s disease, but these diseases have a different classification and characteristic clinical and instrumental criteria.
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