الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The term metatarsalgia refers to pain located in the region of the metatarsal (MT), metatarsophalengeal joint (MTPJ), intermetatarsal space (IS), and submetatarsal soft tissues. It is a frequent presenting complaint in the foot, and common problem in the community. Nearly 80% of the normal population present some form of pain in the metatarsal region over their lifetime.
Metatarsalgia classified into primary, secondary and iatrogenic. Primary metatarsalgia is related to abnormalities in the anatomy of the metatarsals and their relationships, leading to mechanical overload on the affected metatarsus. Secondary metatarsalgia due to systemic diseases such as inflammatory arthropathy, gout, Freiberg’s disease and morton’s neuroma ……etc. Iatrogenic metatarsalgia can occur after failed surgery.
In addition, early detection of the joint involvement would allow the treating physician to interfere in the proper time and use the suitable medications .Based on these facts and on limitations of plain radiographs in detecting radiologic changes, there was a real need for other radiological variables to assess joint affection in patients with arthritis.
Musculoskeletal ultrasound of the joints has been proposed as a non-invasive method for evaluating early synovial and articular involvement in patients with metatarsalgia. The aim of our study was to correlate clinical features with ultrasonographic findings in patient with metatarsalgia.
Twenty patients with pain in forefoot were enrolled in this study for detecting joint inflammatory changes as synovial effusion, hyperplasia, arthritis changes as well as cystic and soft tissue lesions. Joints were also assessed clinically for tenderness, swelling and limited range of motion.
The median age disease onset was 44 years; the median disease duration and age at study entry were 2 years. At the study entry, 14 patients had chronic disease. The right side of foot was more affected than the left one representing 11patients and 8 patients respectively. Both sides were affected in only one patient. , the most affected joints were 1st MTPJ (55%), followed by 2nd MTPJ (30%) then the 3rd MTPJ by (25%) followed by the 5th MTPJ (20%).
Statistically significant correlation was detected between clinical and ultrasound findings. This has been proven in other studies as well. So in conclusion, US is very useful in assessing patients early in the course of the disease as it detects findings in joints even early without apparent clinical presentations.