Clinical features

In the early stages there is pain on motion (dorsiflexion and/or plantar flexion), often with limitation

• symptoms will be aggravated by exercise levels and footwear (either unsupportive shoes, shoes with an increased heel or short shoes causing back pressure into the joint) (1)
• the range of movement gradually becomes more limited with osteophyte formation causing dorsal and medial prominence
• plantar pain may result secondary to involvement of the sesamoids can cause plantar pain
• loss of motion may result in increased load beneath the lesser metatarsals, hence discomfort
• there will often be classical changes of wear of the shoes of the patient
  • deformation of the upper around the joint, reduced wear beneath the first MTPJ and a circular wearing pattern beneath the central metatarsals

Reference:

1. ARC. Common foot disorders. Hands On 2006;10:1-6.