Osteonecrosis de un sesamoideo del pie como causa de metatarsalgia. Aspectos clínico-radiológicos
SEMERGEN - Medicina de Familia(2008)
Abstract
Varón de 37 años de edad con metatarsalgia a la deambulación. El dolor se localizaba en la zona plantar de la primera articulación metatarsofalángica. En la radiografía convencional se objetivó fragmentación y esclerosis heterogénea. La resonancia magnética confirmó el diagnóstico de necrosis avascular del sesamoideo medial. Se trató conservadoramente con medicación antiinflamatoria y medidas ortopédicas. Aunque no existen muchas referencias bibliográficas, la osteonecrosis de los sesamoideos del pie debe ser considerada en el diagnóstico diferencial de la metatarsalgia persistente. A 37-year-old man presented with forefoot pain present with walking. The pain was located in the plantar zone of the first metatarsophalangeal joint. Plain film radiographs revealed fragmentation and heterogeneous sclerosis. Magnetic resonance imaging confirmed the diagnosis of avascular necrosis of the medial sesamoid. He was treated conservatively with metatarsal padding and nonsteroidal anti-inflammatory medications. Although it has not been frequently addressed in the literature, avascular necrosis of the sesamoid bones should be considered in the differential diagnosis of persistent forefoot pain.
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Key words
metatarsalgia,osteonecrosis sesamoideos
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