Foot Pain In A Soccer Player

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Foot Pain In A Soccer Player - Page #4

Working Diagnosis: Osteochondral defect of the proximal phalanx of the right great toe with mild degenerative changes at the right first MTP with moderate underlying subchondral cystic change and edema Treatment: Orthopedics performed a right 1st MTP capsulotomy and debridement with a great toe proximal phalangeal curettage and local bone grafting. Author's Comments: Providers should be aware that x-rays may be normal in patients with an osteochondral defect. If pain continues after conservative treatment and there is a high index of suspicion for an osteochondral defect an MRI is the study of choice for further evaluation and staging. Editor's Comments: This is an interesting and uncommon cause of forefoot pain after trauma, and it is important to note that first MTP osteocondral defect may be a risk factor for hallux rigidus later in life. References: DeLee JC, Drez Jr D, Miller MD. DeLee & <br>Drez's Orthopaedic Sports Medicine <br>Principles and Practice, 2nd Ed, Elsevier <br>Science, Philadelphia 2003. <br> <br>Chambers HG, Shea KG, Carey JL. AAOS Clinical Practice Guideline: diagnosis and treatment of osteochondritis dissecans. J Am Acad Orthop Surg 2011; 19:307. <br> <br>Perumal V, Wall E, Babekir N. Juvenile osteochondritis dissecans of the talus. J Pediatr Orthop 2007; 27:821. <br> <br>Care of the Young Athlete, 2nd ed, Anderson SJ, Harris SS, Gregory AJM (Eds), American Academy of Pediatrics, Elk Grove Village 2010. <br> <br>Moktassi A, Popkin CA, White LM, Murnaghan ML. Imaging of osteochondritis dissecans. Orthop Clin North Am 2012; 43:201. <br> <br>Polousky JD. Juvenile osteochondritis dissecans. Sports Med Arthrosc 2011; 19:56. <br> <br>Harvey BS, Herngenroeder AC. Management of osteochondritis dissecans. UpToDate. Retrieved from http://www.uptodate.com/contents/management-of-osteochondritis-dissecans-ocd?search=osteochondritis+dissecans&source=search_result&selectedTitle=1~27 2017. Return To The Case Studies List.		Back
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