Presentation
Medial foot pain.
Patient Data
Age: 20 years
Gender: Male
From the case:
Lateral hallux sesamoid avascular necrosis
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Lateral hallux sesamoid appears sclerotic. No other abnormality noted.
From the case:
Lateral hallux sesamoid avascular necrosis
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Fragmentation of the lateral hallux sesamoid. No hyperemia. Normal first webspace. Normal first metatarsophalangeal joint.
From the case:
Lateral hallux sesamoid avascular necrosis
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Targetted views of the sesamoid confirms lateral hallux sesamoid sclerosis, fragmentation and mild collapse in keeping with avascular necrosis.
Case Discussion
Avascular necrosis of the hallux sesamoids can be an overlooked cause of medial forefoot pain - the abnormal lateral hallux sesamoid was not picked on the first x-ray.