{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:02:53Z","timestamp":1773273773709,"version":"3.50.1"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Terrapin Station Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"abstract":"<jats:p>Metatarsal head osteonecrosis, also known as Freiberg\u2019s disease, is a painful and debilitating condition that is difficult to treat both nonoperatively and operatively. In this report, we present 2 cases of Freiberg\u2019s disease in a 49-year-old man and 32-year-old woman who were treated using a combination of focused extracorporeal shockwave therapy (F-SWT) with extracorporeal magnetotransduction therapy (EMTT). Extracorporeal shockwave therapy generates high-energy sound waves hypothesized to stimulate tissue healing through multiple pathways including angiogenesis, immunomodulation, and local cellular proliferation and differentiation. Extracorporeal magnetotransduction therapy, while still a very novel technology is understood to generate high-intensity electromagnetic fields, potentially altering cellular signaling to stimulate healing. Following a series of F-SWT and EMTT, these patients had both significant improvement of symptoms and radiologic improvement. They were able to return to activities following treatment. This report highlights that F-SWT and EMTT may be a nonoperative treatment option for metatarsal head osteonecrosis.<\/jats:p>","DOI":"10.1177\/19386400261420294","type":"journal-article","created":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T16:11:09Z","timestamp":1771776669000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal Shockwave Therapy With Extracorporeal Magnetotransduction Therapy for Osteonecrosis of the Metatarsal Head: A Case Series"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8707-5034","authenticated-orcid":false,"given":"Nicole B.","family":"Katz","sequence":"first","affiliation":[{"name":"Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4146-2789","authenticated-orcid":false,"given":"Sydney C.","family":"Karnovsky","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5548-7082","authenticated-orcid":false,"given":"Jennifer K.","family":"Su","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra G.","family":"Beling","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, The University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5370-4907","authenticated-orcid":false,"given":"Guy","family":"Katz","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5996-0557","authenticated-orcid":false,"given":"Alexandra","family":"Berke","sequence":"additional","affiliation":[{"name":"MIT Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3966-8070","authenticated-orcid":false,"given":"Adam S.","family":"Tenforde","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200704000-00004"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1938640015585966"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1938640013510314"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2023.11.016"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12102269"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.12790"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2009-3"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000851"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fvets.2022.851894"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-014-2991-5"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4103\/2319-4170.104413"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2024-109082"}],"container-title":["Foot &amp; 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