- ICD-9= 726.70
- Metatarsalgia = nonspecific term for pain in the lesser metatarsalphalangeal joints.
Metatarsalgia Differential Diagnosis
- The extensor digitorum longus and brevis are generally innervated by the deep peroneal nerve.
- Plantar plate consists of the plantar aponeurosis and the plantar capsule.
- Plantar fat pad: a protective fatty cushion beneath the metatarsal heads; normally connected to the bases of the phalanges.
Metarsalgia Physical Exam
- Anterior drawer test: hold the metatarsal head between the index finger and thumb; grasp the base of the proximal phalanx with the other hand and apply a dorsally directed force. Dorsal displacement and pain indicate metatarsophalangeal joint instability or MTP synovitis.
Metatarsalgia Nonspecific Treatment
- Initially treatment = pre-made flexible orthosis with metatarsal pad or custom-made orthosis
- Secondary treatment = rocker bottom soled shoe
Metatarsalgia Review References