Deutschlander's disease as a microtraumatic injury of the metatarsal bones

An analysis of the X-ray picture in 48 cases of Deutschlander's disease confirms the traumatic origin of its main symptoms - a translucent line and periosteal reaction. They should be regarded as a fracture line and periosteal callus. The disease is characterized by the absence of a severe trauma, a gradual spreading of bone lesion in the process of several successive fractures, frequently resulting in complete bone disintegration, the formation of a zone of microtraumatic lesions with a system of cracks, two-phase or multiphase formation of a massive periosteal callus, and prolonged healing with a prior complete bone tissue resorption within limits of a microtraumatic zone. The above features closely correlate with the microtraumatic concept of the disease. The microtraumatic process is accompanied by intensive rearrangement of the bone tissue within the limits of the affected bone expressed by characteristic X-ray signs. Both interpretations of Deutschlander's disease as a pathological rearrangement and a fracture reflect incompletely the essence of these changes. Taking into accounmt the leading role of microtrauma in the genesis and clinical course of the disease, it should be looked upon as a microtraumatic injury of the metatarsal bones