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Sesamoiditis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

This condition is due to arthritic changes of the surface of the sesamoids at their site of articulation with the plantar head of the first metatarsal

  • patients complain of pain, generally under the first metatarsal head during weight-bearing, and particularly when walking
    • often a patient will complain of pain under the metatarsal head as the weight is taken aound about 'toe-off'
  • a distinct plantar callosity may be detected clinically but will not be the only cause of localised tenderness; also there may be reduction in extension of the first MTP joint
  • similar pain may also be due to fracture or hypertrophy of the sesamoid

Treatment:

  • insoles with an aperture cut to raise the sesamoid off the bottom of the shoe and thus to afford relief via cushioning of the lesion; simple cushioning such as sorbothane insoles and silicone gels applied to the area can also help
  • steroid preparations injected directly into the sesamoid apparatus will also help reduce pain (1)

Reference:

  1. Rheumatic Disease in Practice (September 2001). The therapeutic scope of modern podiatry. Issue number 6, Arthritis Research Campaign.

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