By: Robert H. Sheinberg, D.P.M., D.A.B.P.S., F.A.C.F.A.S.
Arthritis of the sesamoid-metatarsal articulation is relatively common. Arthritis is a degenerative process where the cartilage of the bone starts to wear down. When the cartilage wears down between the sesamoid and the metatarsal, bones start to rub against each other and chronic pain and swelling often develop. This can occur from one traumatic event such as a fall from a height. It can also occur from low-grade stress to the ball of the foot that persists over time. It is very common to see arthritis in the area in patients with bunions or arthritis of the big toe joint. At times the arthritis is relatively asymptomatic and in some cases it can become very painful, limiting all activity. MRIs and occasionally CT scans are necessary to fully evaluate the injury. If pain persists despite conservative care (anti-inflammatories, injections, and orthotics), then surgery would be necessary to remove the sesamoid.