Metatarsalgia is very common and frequently misdiagnosed pathology. It may be static, propulsive or mix type and it occurs due to various factors, such as, cavus foot, Achilles shortening, changes in metatarsal alignment, 1st ray insufficiency, hallux valgus, among others.
The initial treatment is usually through the prescription of customized orthotics with specific corrections. Active vigilance should be done to avoid the progression of the disease leading to joint instability and subsequent toe deformities (Left).
In diabetic patients, a tight surveillance of the skin is very important, because the loss of sensation and frequent complex deformities complexas associated to Charcot foot, easily develop ulcers that may infect, leading to a condition that is difficult to manage. In the pictures, an ulcer in a diabetic foot that was treated with full contact cast, is illustrated.

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