bunion

Introduction

A localized swelling at the medial or dorsal aspect of the 1st metatarsophalangeal joint generally associated with hallux valgus.

Etiology

• ill fitting shoes
• ballet dancing
• long-distance running
• hallux valgus

Epidemiology

• more common in women

Pathology

• inflammed bursa

Genetics

• family history in 3-5%

Clinical manifestations

• a medial bunion is generally associated with hallux valgus
• callus or bursitis over the bony prominence

Radiology

• plain x-ray if surgical correction is considered
  • radiographic evidence of a large angle between the proximal phalanx & the first metatarsal head

Differential diagnosis

• Rheumatoid arthritis
• Gout
• Pseudogout
• Bursitis
• Tendonitis
• Tenosynovitis
• Fibrositis
• Degenerative joint disease
• Traumatic joint injury

Management

• more appropriate footwear
  • little evidence conservative measures including orthosis or more appropriate footwear effective
• also see hallux valgus
• surgery if conservative measures fail (bunionectomy)

More general terms

• joint disease; articular disease; arthropathy
• foot deformity

More specific terms

• tailors's bunion