hallux limitus/rigidus
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Etiology
- osteoarthritis of the 1st metatarsophalangeal (MTP) joint with dorsal osteophyte
Clinical manifestations
- pain in great toe
- pain exacerbated with dorsiflexion of great toe
- enlargement of 1st MTP joint
- limited dorsiflexion of great toe
- crepitus
- pain with walking
Radiology
- X-ray of foot
- joint space narrowing
- marginal exostosis formation -subchondral sclerosis
Management
- analgesics
- physical therapy: ultrasound
- glucocorticoid injection
- very short-term & minimal relief of symptoms from acute exacerbation
- foot surgery under local anesthesia (safe, effective, 1st line[1])
- arthrodesis vs implant arthroplasty of the 1st MTP joint
- mechanical bridging of MTP joint to reduce dorsiflexion
- arthroplasty or joint replacement
- remove spurs
- restore motion
More general terms
Additional terms
References
- ↑ Jump up to: 1.0 1.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019 - ↑ Park YH, Jung JH, Kang SH, Choi GW, Kim HJ. Implant Arthroplasty versus Arthrodesis for the Treatment of Advanced Hallux Rigidus: A Meta-analysis of Comparative Studies. J Foot Ankle Surg. 2019 Jan;58(1):137-143. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30583775
- ↑ Hamid KS, Parekh SG. Clinical Presentation and Management of Hallux Rigidus. Foot Ankle Clin. 2015 Sep;20(3):391-9. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26320554
- ↑ Kunnasegaran R, Thevendran G. Hallux Rigidus: Nonoperative Treatment and Orthotics. Foot Ankle Clin. 2015 Sep;20(3):401-12. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26320555
- ↑ Drago S, Nazaroff H, Britton J, et al. Assessment and management of atraumatic first metatarsophalangeal joint pain. J Am Acad Orthop Surg. 2023;31(14):708-716 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37126849