Hallux rigidus (metatarsophalangeal joint arthritis).

Hallux rigidus frequently is responsible for foot pain.

Pain in the big toe can be caused by a hallux rigidus.

Pain in the big toe can be caused by a hallux rigidus.

Pain when standing, walking problems and limited movement of the big toe: arthritis in the metatarsophalangeal joint (also known as joint degeneration) of the big toe is a common cause of pain and limited mobility in the foot.

Arthritis is typically a disease of the second half of life. However, younger people can also suffer premature joint degeneration, e.g. after injury. Various analyses have indicated that there may be a family disposition. The idea of a hereditary predisposition is supported by the fact that the metatarsophalangeal joints in both big toes are affected to a greater or lesser extent in some 80 % of patients. Many patients also report that their father or mother experienced similar changes. Unlike hallux valgus, the misalignment of the big toe, which predominantly affects women, roughly equal proportions of men and women are affected by hallux rigidus.

 

Hallux rigidus. Information from A-Z

Definition. What is Hallux rigidus?

What is arthritis of the metatarsophalangeal joint?

Arthritis of the metatarsophalangeal joint encompasses the typical hallmarks of a wearing of the joint with limited mobility, pains, bone spurs (so called osteophytes), especially on the top of the joint, as well as a narrowing of the joint space in the x-ray. Depending on the stage of the disease, there may be different distinctive symptoms. The initial signs of arthritis of the metatarsophalangeal joint are mostly pains in the joint associated with limited mobility of the foot.

 

The stages of Hallux rigidus.

It is possible to distinguish between 4 stages of the illness:

 

Grade I:

Reduction of the scope of movement of 20-50%, in comparison to a healthy state. Occurrence of pain depending on time and load with maximum movement of the hallux. In the x-ray, a small bony spur can be found in the direction of the back of the foot in a largely normal joint space.

 

Grade II:

Hallux rigidus. Grade II

Hallux rigidus. Grade II

Reduction of the range of movement by 50-75%, in comparison to a healthy state. Moderate, sometimes even severe, pain associated with the subjective feeling of a stiff big toe. The x-ray already shows a significant level of joint space narrowing.

 

Grade III:

Reduction of the range of movement by 75-100%, in comparison to a healthy state. In particular, the upward movement is often completely neutralised. The pain in the metatarsophalangeal joint occurs consistently with increased strength under strain. The x-rays show a severely narrow joint space and associated large bone spurs that especially protrude out towards the top of the foot.

 

Grade IV:

Left: Grade III. Right: Grade IV.

Left: Grade III. Right: Grade IV.

Reduction of the range of movement by 75-100%, in comparison to a healthy state. There are persistent complaints, increasing in strength in dependence on the strain. 'The X-ray shows complete joint space effacement.

 

Symptoms. Signs of Hallux rigidus

Typical signs of metatarsophalangeal joint arthritis.

Symptoms & discomfort of Hallux rigidus.

Symptoms & discomfort of Hallux rigidus.

Pain, posture and movement restriction. The following symptoms typically occur with osteoarthritis in the big toe joint (Hallux rigidus):

 

  • Restricted mobility, especially when lifting the big toe up
  • Painful bony growth, particularly painful in closed shoes
  • These bony growths extend towards the back of the foot and are not to be confused with the enlarged ball of the big toe in hallux valgus (malpositioning of the big toe)  
  • Pain when placing pressure on the joint at the base of the big toe, associated with swelling and reddening
  • Overloading symptoms in the joints at the bases of the 2nd to 5th toes as well as symptoms along the outer edge of the foot. Patients often unconsciously try to relieve the joint at the base of the big toe and load the outer edge of the foot more during heel-toe gait. The foot is not constructed for this type of stress and reacts with unspecific, diffuse pain that is often difficult to localise.
 

Diagnostics & Therapy

Both the conservative and surgical treatment concepts depend on the severity of the metatarsophalangeal joint arthritis.

Diagnostics & Therapy

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