Hallux sesamoid fracture
Painful forefoot, swollen painful 1st MTP joint.
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Alignment is normal. There is a bipartite medial hallux sesamoid bone which represents a normal variant. The adjacent lateral sesamoid demonstrates an oblique linear lucency that may represent a fracture, alternatively it may represent a bipartite sesamoid.
The patient reported increase in running activity recently. On further examination pain was exacerbated by hallux MTP joint hyperextension.
The large medial sesamoid in more commonly injuried than the lateral sesamoid, related to greater weight bearing.