Avascular necrosis of the epiphysis of the first metatarsal bone.
ABSTRACT We report a case of avascular necrosis of the epiphysis of the right first metatarsal in a 6-year-old boy. Radiographs showed sclerosis, collapse and a crescent sign in the epiphysis. The diagnosis was confirmed by magnetic resonance imaging and scintigraphy. Arch support was the therapy of choice. Six months after the onset of symptoms, a definite reossification was present. To our knowledge, this is the first radiological report of avascular necrosis of the epiphysis of the first metatarsal bone in the world literature, which prompted a review of the osteochondroses and their etiology.
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ABSTRACT: Idiopathic avascular necrosis of first metatarsophalangeal head in child is unique condition not described in literature in past exlude one case. It seems to be part of avascular bone necrosis syndromes, like Freiberg disease, Sever disease etc. and the same principles of treatment are appropriate in AVN of 1st MTT head. We describe the case of bilateral AVN of 1st MTT head treated conservatively with complete cure.Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca 11/2008; 75(5):396-8. · 1.63 Impact Factor
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ABSTRACT: Bone scan is a sensitive tool for evaluating cause of bone pain in symptomatic patients especially when other clinical or imaging modalities can not provide enough information for diagnosis. A 64-year-old woman visited our orthopedic department complaining of left foot pain without other signs or symptoms. Due to per-sistent pain which was unresponsive to treatment and unexplained by X-ray finding of fracture, the patient underwent a whole body bone scan. The scintigraphic finding showed focally increased radiotracer uptake at the third left metatarsal bone especially in the head region. In view of clinical history, there was long-term repetitive stress on the patient's feet; therefore, we sug-gested the possibility of aseptic necrosis (Freiberg's disease). Finally, a biopsy was done and the pathology revealed osteonecrosis of the third left metatarsal bone. Our case demonstrates an uncommon site of osteonecrosis with a typical pattern of radiotracer uptake which assisted in the diagnosis of osteonecro-sis. Furthermore, bone scan serves as an initial and non-invasive role in determining the need for further management.