30. Neurodystrophic Metatarsalgia

Neurodystrophic metatarsalgia is related to the algodystrophic reflex syndrome. It is also known as Sudeck’s atrophy, and has been given numerous other names, including angioneurodystrophic decalcification, Sudeck-Leriche syndrome, neurotrophic rheumatism or arthropathy, painful foot with oedema and decalcification, sympathetic dystrophic reflex, painful idiopathic decalcification of the foot (Ravault et al. 1959; Ravault and Bouvier 1966), Destot (1911), bony atrophy, post-traumatic algic osteoporosis (Leriche and Fontaine 1930) and algodystrophic sympathetic syndrome (de Seze and Ryckewaert 1954). The painful condition may affect the extremities of the upper or lower limb. Authors agree that it is due to disturbance of the neurovegetative innervative reflexes, usually of the peripheral nociceptive type but sometimes central in origin.