No one knows the exact cause, although it is probably due to circulation disturbance to that part of the bone. Osteochondrosis can occur in many areas of the body, but the more common examples are as follows. Freiberg s disease occurs in the head of the metatarsals of the foot, usually the 2 nd or 3 rd metatarsal, usually between the ages of 12 to 15, and more commonly in a girl. The patient presents with pain with walking and is tender over the metatarsal head involved. X-rays show collapse of the metatarsal head.
Treatment includes use of metatarsal pad to relieve pressure on the area while walking.
Sometimes, a piece of the involved bone gets loose, and becomes a loose body in the joint, necessitating surgical excision. Eventually the metatarsal head reforms, and the pain resolves, although the head is usually a little flattened. Kienbock s disease occurs in the lunate of the hand. It usually occurs in patients age 20 to 30 years of age, more commonly in males. Kohler s disease occurs in the navicular bone of the foot, and occurs in children between 3 and 9 years of age.