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Clinical features

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In the early stages there is pain on motion (dorsiflexion and/or plantar flexion), often with limitation

  • symptoms will be aggravated by exercise levels and footwear (either unsupportive shoes, shoes with an increased heel or short shoes causing back pressure into the joint) (1)
  • the range of movement gradually becomes more limited with osteophyte formation causing dorsal and medial prominence
  • plantar pain may result secondary to involvement of the sesamoids can cause plantar pain
  • loss of motion may result in increased load beneath the lesser metatarsals, hence discomfort
  • there will often be classical changes of wear of the shoes of the patient
    • deformation of the upper around the joint, reduced wear beneath the first MTPJ and a circular wearing pattern beneath the central metatarsals

Reference:

  1. ARC. Common foot disorders. Hands On 2006;10:1-6.

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