Understanding hallux valgus deformity: what the surgeon wants to know from the conventional radiograph

Hallux valgus deformity is a common and a significant source of symptoms. It can interfere with daily activities and affects the quality of life of many people. Imaging evaluation is performed almost exclusively by conventional radiography and systematic evaluation of the conventional radiograph can provide the clinician with the necessary information to choose the correct surgical procedure. The radiologist should appreciate the various sites of angular deformity that can be associated with hallux valgus deformity, the nature of the articulations within the first ray, the presence of a bunion, the degree of sesamoid subluxation, and the quality of the bone stock. Systematic radiographic evaluation is vital for ensuring a good surgical outcome. All the conventional radiographic features that influence management are defined and quantified within this review and, importantly, their clinical significance is highlighted, allowing for a more purposeful radiographic interpretation.