Lateral hallux sesamoid avascular necrosis

Case contributed by Dr Henry Knipe

Presentation

Medial foot pain.

Patient Data

Age: 20 years
Gender: Male

Lateral hallux sesamoid appears sclerotic. No other abnormality noted. 

Ultrasound

Fragmentation of the lateral hallux sesamoid. No hyperemia. Normal first webspace.  Normal first metatarsophalangeal joint. 

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. 

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Case information

rID: 62421
Published: 16th Aug 2018
Last edited: 17th Aug 2018
Inclusion in quiz mode: Included

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