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Sesamoiditis

Neil Feldman, DPM Reviewed 06/2019
 


BASICS

DESCRIPTION

Pain and/or inflammation (with minimal or no radiographic change) of one or both of the two sesamoid bones embedded in the flexor hallucis brevis tendon under the 1st metatarsophalan...

DIAGNOSIS

HISTORY

  • Acute or gradual onset of forefoot pain, which is exacerbated by direct pressure, weight-bearing, and flexion/extension of the great toe

  • In contrast, if there is a history of trauma, w...

TREATMENT

GENERAL MEASURES

  • Decreased weight-bearing/activity modification

  • Off-loading of the MTP joint, which can be achieved with (2)[C]:

    • Rocker sole shoes

    • Walking boot or cast immobilization

    • Soft-soled...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Continue conservative management for 8 weeks.

  • Follow up at 1, 4, and 8 weeks to assess pain and function.

Patient Monitoring

  • If pain does not improve within 2 to 4 w...

REFERENCES

1
Kadakia AR, Molloy A. Current concepts review: traumatic disorders of the first metatarsophalangeal joint and sesamoid complex. Foot Ankle Int.  2011;32(8):834–839. [View Abstract on ...

ADDITIONAL READING

  • Nix SE, Vicenzino BT, Collins NJ, et al. Characteristics of foot structure and footwear associated with hallux valgus: a systematic review. Osteoarthritis Cartilage.  2012;20(1...

CODES

ICD10

  • M25.879 Other specified joint disorders, unspecified ankle and foot

  • M25.872 Other specified joint disorders, left ankle and foot

  • M25.871 Other specified joint disorders, right ankle and foot

ICD9

CLINICAL PEARLS

  • Sesamoiditis is most commonly seen with repetitive axial loading of 1st MTP.

  • Sesamoid arthritis is very common with hallux abducto valgus (bunions), hallux limitus, and hallux rigidus.

  • S...

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