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Have a patient who presented with metatarsalgia and after some investigation, and a MRI has an AV malformation near the area of pain , I have sent the patient for further investigation, aterioveinous malformation was a new one on me , has anyone come across this presenting as metataraslgia.The patient was female . 70 years old sudden, onset red at times
Tim

 

Hi Tim yes I have seen this before - a very severe case in a young boy - apparently its not as common in feet, and if I remember correctly it more so occurs in the brain and is mostly fatal at a young age. We managed our patient as he was having general foot pain - we thought it was predominantly due to the AVM syndrome however he responded very well to orthoses to normalie plantar pressures. We padded to entire orthoses from memory in spenco and poron and used an EVA shell for support - we also placed him in excellen footwear. He returned to playing football soon after with no reports of pain. Excluding any other pathology in th region, the AVMS may be difficult to manage. I'm not up on any of the latest vascular techniques to manage this issue. Very interesting cases. Good luck!

 

Hi Paul
Thanks for the reply I have chatted to a few people and a physio I spoke to hs seen it in in-patients as a brain lesion, I have referred it to a vascular consultant but will follow it and let you know the outcome (minus 7 in blighty!)
Tim