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In arriving at a primary Diagnosis (Dx), due consideration should be given to differential diagnoses (Ddx), which must of course include metatarsal stress fractures (Reeder et al, 1996), as well as Metatarsophalangeal Joint (MTPJ) synovitis, osteochondrosis of the (usually but not exclusively 2nd) metatarsal heads (Freiberg infraction/disease), gout, sesamoiditis and more rarely encountered pathologies such as plantar verrucous carcinoma (Schell et al, 2001) and epidermal inclusion cysts (Kato and Ueno, 1992).
I've used the exercise illustrated in figure 5 to treat recurrent metatarsal stress fractures with excellent results.