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Hallux rigidus

Hallux Rigidus Genève

What is it?

Hallux rigidus is arthritis of the big toe (called hallux), particularly the joint between the metatarsal and the phalanx. Arthritis is defined by as wear and tear to the cartilage, which is the white tissue covering the bone in joints. Cartilage loss is irreversible. It gradually causes the joint to stiffen and triggers rapid changes to its mobility (it becomes rigid). The progression of the disease is characterised by the development of growths or bony spurs around the joint (= osteophytes). This results in mechanical conflicts among these growths or spurs or, when they are large, a direct conflict with the shoe. Three types of discomfort occur with this condition: loss of mobility, joint pain and the development of osteophytes.

Hallux Rigidus
  • Fig. 1

    Normal hallux
    The joint is covered by cartilage

  • Fig. 2

    Hallux rigidus
    Destruction of the surface of the joint and development of osteophytes at its periphery

Although joint pain due to the loss of cartilaginous cover is only experienced at a very late stage, the development of osteophytes rapidly causes a problem. In fact, the mobility of the joint depends on the congruence of its two surfaces, namely a hemisphere articulating with a cup. Osteophytes inevitably cause conflict, particularly with dorsiflexion (extension) movements of the toe.

  • Fig. 1

    Normal hallux
    Complete mobility

  • Fig. 2

    Hallux rigidus
    Conflict between the phalanx and the osteophyte, blocking the movement

Hallux normal vs Hallux rigidus

Clinical presentation

Usually, the mobility of the big toe is considerably reduced and it may be painful when mobilised or in dorsiflexion, when the phalanx comes into conflict with the osteophyte.

When the size of the osteophyte is large, it causes a direct friction with the shoe, which is extremely incapacitating.

When should you consult a specialist?

Decreased mobility is not usually a reason for consultation. If considerable pain is experienced during movements or when putting on shoes it is advisable to see a specialist.

The clinical examination is completed by a radiological assessment to locate the position of the osteophytes and to determine the degree of severity of the condition.

Do you have any questions or would you like to see a specialist?

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