Die Metatarsalgie als belastungsabhängiger Schmerz besonders im Bereich der Metatarsaleköpfchen
II–V hat vielfältige Ursachen. In der für die Diagnosestellung wichtigen Bildgebung
spielt die MRT eine entscheidende Rolle. Im Folgenden werden die Differenzialdiagnosen
der Metatarsalgie und die typischen Befunde der verursachenden Erkrankungen und Veränderungen
dargestellt.
Abstract
Metatarsalgia is defined as a load-dependent pain under or around the lesser metatarsal
heads II–V and their joints. A thorough understanding of the variety of underlying
causes is crucial to choose the suitable treatment. Anamnesis and physical examination
combined with weight-bearing radiographs help to refine the various etiologies.
Common causes are congenital shortening of the first metatarsal bone, congenital deformities
of the metatarsal heads with increased plantar alignment or differences in the length
of individual metatarsals.
The additional use of magnetic resonance (MR) imaging allows further assessment of
many forefoot disorders, concerning neurovascular (Morton’s neuroma), joint capsule
(lesion of the plantar plate), osseous (Freiberg’s disease, stress fracture), muscular
(atrophy) and subcutaneous (adventitious bursitis, fat atrophy) structures. High resolution
MR imaging helps to detect pathologies in the small-sized anatomy of the forefoot
and therefore to opt for optimal conservative or operative therapy.
Schlüsselwörter
Metatarsalgie - MRT - Morton-Neurom - plantare Platte - Morbus Freiberg-Köhler
Keywords
Metatarsalgia - MRI - Morton Neuroma - Plantar Plate - Freiberg's Disease
