Patient presents with stiffness and pain in the great toe.
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There is advanced degenerative change at the first MTP joint, out of proportion to the rest of the foot. Osteophytosis, subchondral sclerosis, and marked joint space loss is compatible with osteoarthrosis. There are no juxta-articular erosions and no radiographic evidence of gout (which was also on the clinical differential, given the location of the pain).
Marked degenerative change of the sesamoids and more mild degenerative change at the 1st digit IP joint.
There may be a very slight Frieberg infraction at the head of the second digit metatarsal as well, best seen on the oblique view.
Advanced degenerative change at the 1st digit MTP joint, combined with functional limitation at the joint, is compatible with the term "hallux rigidus".