Metatarsalgia Etiology / Epidemiology / Natural History
Metatarsalgia = nonspecific term for pain in the lesser metatarsalphalangeal joints.
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.
Metatarsalgia Clinical Evaluation
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 Xray / Diagnositc Tests
Foot films generally normal.
Metatarsalgia Classification / Treatment
Initially treatment = pre-made flexible orthosis with metatarsal pad or custom-made orthosis