Q: How can one differentiate between a bipartite/multipartite hallux sesmoid and a fracture of a hallux sesamoid? show answer
Bipartite hallux sesamoid
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Reduced bone density with degenerative changes.
There is a bipartite medial hallux sesmoid.
Two tiny ossicles in between heads of 4th and 5th metatarsals representing additional small sesamoid bones.
This case might prompt a differential diagnosis of bipartite hallux sesamoid vs. hallux sesamoid fracture.
Important points to differentiate between bipartite over a fractured sesamoid are:
- transverse lucency
- smooth, well-corticated margins
are favored in a bipartite sesamoid.
- Taylor JA, Sartoris DJ, Huang GS et-al. Painful conditions affecting the first metatarsal sesamoid bones. Radiographics. 1993;13 (4): 817-30.