Osteochondritis dissecans - hallux interphalangeal joint

Case contributed by Dr Roberto Schubert

Presentation

Recurrent pain of the great toe in a juvenile soccer player.

Patient Data

Age: 10 years
Gender: Male

A small lentiform fragment at the medial base of the distal phalanx surrounded by a radiolucent rim.

Case Discussion

Hallux osteochondritis dissecans is a sports-related injury that is likely caused by hyperflexion or hyperextension of the interphalangeal (or metatarsophalangeal) joint. If the avascular fragment turns into a loose body, it must be removed surgically 1.

Also visible on the images is a so-called cleft epiphysis at the base of the proximal phalanx. This is a normal variant and must not be taken for a fracture.

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