Osteochondritis dissecans of the hallux IP joint
Recurrent pain of the great toe in a juvenile soccer player.
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Small lentiform fragment at the medial base of the distal phalanx surrounded by a radiolucent rim.
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 surgically1.
Also visible on the images is a so-called cleft epiphysis at the base of the proximal phlalanx. This is a normal variant and must not be taken for a fracture.