Synovitis

PREDISLOCATION SYNDROME (Synovitis)
By: Robert H. Sheinberg, D.P.M., D.A.B.F.A.S., F.A.C.F.A.S.

PROBLEM:

• Drifting of the second toe towards the big toe, causing pain, deformity and early development of an overlapping second toe over the big toe.

CAUSE:

• Trauma to the second toe joint causing inflammation in that region.
• Inflammation of the nerves on the ball of the foot (neuroma).
• Long second toe or second metatarsal, causing a hammertoe and excess stress on the ball of the foot.
• Weakness or tearing of the ligament holding the second toe straight.
• Pressure on the second toe from a bunion deformity.
• Pressure on the second toe due to a crooked big toe (hallux deformity).

SIGNS & SYMPTOMS:

• Visible space between second and third toe while weight-bearing.
• Pain to the second toe that increases with walking.
• Difficulty walking barefoot and unable to wear heels.
• Drifting of the second toe towards or over the first toe (overlapping toe).
• Hammertoe of the second toe.
• Neuritis (inflamed nerve causing numbness, burning and tingling).
• Associated with bunion deformity and/or crooked big toe.
• Swelling of the second toe and/or ball of the foot.
• Callus (hard skin) on the ball of the foot.

TREATMENT:

• Anti-inflammatories to decrease inflammation and stiff-soled shoes to prevent toe bending.
• Taping of the toes to lessen the pain and deformity.
• Surgery to realign the joint and possibly remove the nerve to achieve full recovery.

PROGNOSIS:

• Excellent with regard to eliminating the pain and deformity. The earlier the treatment, the better the long-term prognosis.