Bilateral osteochondritis dissecans of the first metatarsophalangeal joint.

The authors present a review of the literature concerning the pathogenesis, diagnosis, and treatment of osteochondral defects of the lower extremity. A case of bilateral osteochondritis dissecans of the first metatarsophalangeal joint in a 43-year-old female is presented, including surgical treatment with 1- and 3-year follow-up examinations. The correlation between articular damage to the first metatarsal head and concomitant hallux limitus and hallux rigidus is discussed. The authors also propose that osteochondritis dissecans lesions almost always occur on the convex surface of a joint because of a convergence of impaction forces.