Topics

Topic

design image
Head of metatarsal bone

The head of the metatarsal bone forms the distal rounded portion of each metatarsal, articulating with the base of its corresponding proximal phalanx to form the metatarsophalangeal (MTP) joint. The head is covered with hyaline cartilage and supported by a strong capsuloligamentous complex that provides both stability and flexibility during gait.

The metatarsal head plays a key role in weight distribution, shock absorption, and propulsion of the foot during walking and running. The first metatarsal head bears the greatest load, articulating with the sesamoid bones and the base of the proximal phalanx of the hallux, while the other metatarsal heads form the transverse arch of the forefoot.

Synonyms

  • Distal metatarsal head

  • Articular end of the metatarsal

  • Metatarsal condyle

Location and Articulations

  • Location: Distal end of each metatarsal bone in the forefoot

  • Articulations:

    • Proximal phalanx: via the metatarsophalangeal joint

    • Sesamoid bones (first metatarsal): embedded within the plantar plate and flexor hallucis brevis tendons

    • Adjacent metatarsal heads: interconnected by the deep transverse metatarsal ligament

Surfaces and Features

  • Articular surface: Convex and smooth, covered with hyaline cartilage

  • Plantar aspect: Groove for the plantar plate and flexor tendons

  • Dorsal surface: Covered by the joint capsule and extensor tendons

  • Collateral margins: Attachment sites for collateral ligaments of the MTP joint

Attachments

  • Joint capsule: Surrounds the MTP joint, attaching around articular margins

  • Collateral ligaments: Provide mediolateral stability

  • Plantar plate: Thick fibrocartilaginous structure reinforcing plantar surface

  • Tendons:

    • Flexor tendons pass plantar to the head (flexor digitorum longus and brevis, flexor hallucis brevis in first metatarsal)

    • Extensor tendons cross dorsally over the joint (extensor digitorum longus/brevis, or extensor hallucis longus in first toe)

Relations

  • Dorsally: Extensor tendons and dorsal digital nerves and vessels

  • Plantarly: Plantar plate, flexor tendons, and digital branches of plantar nerves and arteries

  • Laterally and medially: Collateral ligaments and intermetatarsal spaces

  • Proximally: Metatarsal shaft

  • Distally: Base of proximal phalanx

Arterial Supply

  • Dorsal metatarsal arteries (from arcuate artery)

  • Plantar metatarsal arteries (from deep plantar arch)

  • Nutrient branches penetrate cortex near metaphyseal region

Venous Drainage

  • Dorsal digital veins draining into the dorsal venous arch

  • Plantar veins draining to the posterior tibial venous system

Function

  • Weight-bearing: Distributes load during stance and push-off

  • Shock absorption: Cushions ground reaction forces

  • Propulsion: Acts as a lever for forward motion

  • Arch support: Forms the transverse and longitudinal arches of the forefoot

  • Joint flexibility: Enables dorsiflexion, plantarflexion, and limited lateral movement of the toes

Clinical Significance

  • Fractures: Common in forefoot trauma and stress injuries (especially 2nd and 5th metatarsal heads)

  • Avascular necrosis: Affects the second metatarsal head (Freiberg’s infraction)

  • Osteoarthritis: Degeneration of the first MTP joint (hallux rigidus)

  • Dislocations: Occur in high-energy trauma or repetitive overload

  • Sesamoid disorders: Associated with the first metatarsal head in runners and ballet dancers

  • Imaging importance: MRI and CT essential for detecting stress fractures, necrosis, and cartilage defects

MRI Appearance

  • T1-weighted images:

    • Normal marrow: bright signal, reflecting fat-rich cancellous bone

    • Cortex: low signal (dark)

    • Cartilage: thin, intermediate-to-low signal cap on the articular surface

    • Pathology: fracture, necrosis, or marrow edema appears low signal replacing normal fat intensity

  • T2-weighted images:

    • Normal marrow: bright signal, depending on fat content

    • Cortex: dark hypointense rim

    • Cartilage: intermediate-to-bright

    • Fractures or subchondral cysts: hyperintense lines or foci

    • Osteonecrosis: heterogeneous signal with surrounding hyperintense rim of reactive edema

  • STIR:

    • Normal marrow: dark signal (fat suppression)

    • Pathology: bright hyperintense signal indicating edema, inflammation, or fracture

    • Excellent for detecting early stress injuries and bone contusions

  • Proton Density Fat-Saturated (PD FS):

    • Normal marrow: dark (suppressed fat)

    • Pathology: bright signal indicating marrow edema, subchondral cyst, or infection

    • Useful for assessing cartilage thinning and subchondral bone changes

  • T1 Fat-Sat Post-Contrast:

    • Normal bone: minimal homogeneous enhancement

    • Osteonecrosis: peripheral rim enhancement with central non-enhancing zone

    • Active arthritis or osteomyelitis: intense marrow and soft-tissue enhancement

CT Appearance

Non-Contrast CT:

  • Excellent for cortical detail and subchondral bone evaluation

  • Normal head shows smooth convex articular surface with cortical shell and trabecular pattern

  • Fractures: visible as cortical breaks or sclerotic lines in stress fractures

  • Osteonecrosis: shows sclerosis, fragmentation, or flattening of the metatarsal head

  • Osteoarthritis: joint space narrowing and marginal osteophyte formation

Post-Contrast CT (standard):

  • Limited role for osseous structures

  • May show enhancement in inflammatory or infectious changes around MTP joint

  • Excellent for bony alignment, fractures, and degenerative remodeling

CT VRT 3D image

head of the metatarsal bone ct 3d vrt image

MRI image

head of the metatarsal bone coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

CT image

head of the metatarsal bone ct sag image

MRI image

head of metatarsal bone coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

MRI image

head of metatarsal bone SAG cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000