Interphalangeal

ARTHRITIS OF THE TOES
By:  Robert H. Sheinberg, D.P.M., D.A.B.P.S., F.A.C.F.A.S.

CAUSES:

  • Trauma to the top of the digits.
  • Fractures that healed with displacement causing the joint surface to be irregular.
  • Hammertoes, mallet toes or clawtoe deformities that have progressed over a long period of time.
  • Rheumatoid arthritis.
  • Psoriatic arthritis.

SIGNS AND SYMPTOMS:

  • The joint afflicted with the arthritis may appear to be abnormally large.
  • A loss of motion of the second toe joint.
  • Difficulty wearing closed shoes, especially heels.
  • Diffusely tender.
  • Occasionally red.
  • If associated with certain types of arthritis it may appear to be significantly enlarged relative to the other toes (sausage toe).

X-RAYS:

  • Usually reveal joint space narrowing and deformity.  May also reveal erosions of the joint indicative of underlying synovial tissue disease.  May also reveal old trauma to the area that healed out of alignment. 

TREATMENT:

  • In very mild cases a steroid injection in and around the joint may significantly reduce the inflammation and pain.
  • Wider shoes to accommodate the area.
  • If synovial tissue disease is causing the underlying problem, medical treatment may be necessary to treat the disease process.
  • Surgery to permanently correct the problem.  This can include either removing or fusing the joint to completely eliminate the pain and deformity.  A complete return to shoe gear and activity is usually the norm following the healing process.  No long-term adverse affects have been associated with removal of the arthritic joint or fusing it.

 

Changes in the bones cortex from pathological condition such as arthritis or bone infection with irregularity within the hallux interphalangeal joint.

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