Absence of the medial sesamoid bone associated with metatarsophalangeal pain

Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
Ulunay KanatliHaluk Yetkin

Abstract

Pain at the first metatarsophalangeal (MTP) joint can result from inflammation, chondromalacia, flexor hallucis brevis tendinitis, osteochondritis dessecans, fracture of a sesamoid bone, avascular necrosis of sesamoids, inflamed bursae, intractable keratoses, infection, sesamoiditis, gout arthropathy, and rheumatoid arthritis. Congenital absence of a sesamoid bone is extremely rare. We present a 17-year-old male patient with pain at the plantar aspect of the right MTP joint associated with congenital absence of the medial sesamoid. There was tenderness and the range of motion was minimally restricted. He described the pain as necessitating changes in his social life. On radiographs, the medial hallucial sesamoid was absent on the right side. The MTP joint was also evaluated using magnetic resonance imaging (MRI). A metatarsal pad was prescribed and the patient was satisfied with the treatment at the 2 months follow-up period. MRI revealed no pathological tissue at the medial sesamoid site. Hallucial sesamoids absorb pressure, reduce friction, protect the tendons, act like a fulcrum to increase the mechanical force of the tendons, and provide a dynamic function to the great toe by elevating first metatarsal head. Congenital abse...Continue Reading

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Citations

Oct 3, 2014·Journal of the American Podiatric Medical Association·Garry ShtofmakherRandy E Cohen
Jan 17, 2013·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Tun Hing Lui, Kwok Fai Tam
Feb 1, 2011·Clinics in Podiatric Medicine and Surgery·Daniel K LeeAlexandra K Schwartz
Feb 24, 2009·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Geraint WilliamsSimon Platt
Nov 29, 2008·Radiologic Clinics of North America·Timothy G Sanders, Sharik Kabir Rathur
Dec 17, 2008·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Ignacio Martínez GarridoVicente Vicent Carsí
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May 15, 2009·Foot & Ankle International·Timothy H D WilliamsAndrew H N Robinson
Mar 1, 2012·Revista Brasileira De Ortopedia·Carlyle Marques BarralFernando Santana Machado

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