- Atraumatic forefoot pain.
- Primary differential diagnosis is a metatarsal stress fracture.
- Patients typically complain of pain beneath the metatarsal heads on weight bearing.
- A plain radiograph may be performed to see any structural cause for the callosity.
Conservative measures include
- Avoid activities that exacerbate symptoms.
- Patient education.
- Shoe wear advice – avoid totally flat, high, or tight shoes. Trainers are appropriate.
- OTC orthotics if flat footed.
- Diagnostic uncertainty.
- Pain preventing day to day activities.
- Failure of conservative measures after a minimum of 6 weeks.