Diagnosis and treatment of forefoot disorders. Section 2. Central metatarsalgia.

Central metatarsalgia involves pathology of the second, third, and fourth metatarsals and their respective metatarsophalangeal joints (MPJs). Metatarsal pathology may be secondary to a variety of problems including trauma, length abnormalities, structural deformity, and others. Pathology of the central MPJs is also secondary to numerous different etiologies and encompasses both osseous and soft tissue conditions. Osseous changes may be secondary to arthritis, whereas soft tissue conditions can be complex, often leading to instability of the MPJ and resultant multiplanar deformities. Systemic inflammatory conditions may produce both osseous and soft tissue abnormalities in the areas of the central MPJs.