condition most commonly occurs in the over pronated foot but can occur in the supinated foot
exostosis (benign osteochondroma) most frequently seen is that at the base of the first metatarso-cuneiform joint - often incorporating the base of the second and intermediate cuneiform joints
patients complain of midfoot pain on weight-bearing; also complains of discomfort due to shoe abrasion
in the supinated foot, a dorsal exostosis may be seen around the naviculo-cuneiform and/or talo-navicular regions - again the biggest problem is shoe wear causing discomfort on weight bearing
Management:
early stages orthotics reduce excessive movement and reduces pain; may be used in conjunction with steroid injections directly into the joint (s) under radiographic guidance
if a large exostosis causes intractable and severe pain then surgical removal is indicated; an alternative is fusion of the joint
Reference:
Rheumatic Disease in Practice (September 2001). The therapeutic scope of modern podiatry. Issue number 6, Arthritis Research Campaign.
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