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Functional hallux rigidus in the rheumatoid foot
1Denver Orthopaedic Clinic, Colorado.
Clinical Orthopaedics and Related Research
|October 1, 1991
Summary
Functional hallux rigidus, a loss of toe motion in rheumatoid arthritis patients, can occur without joint damage. This condition may lead to secondary deformities like interphalangeal hyperextension.
Area of Science:
- Orthopedics
- Rheumatology
- Podiatry
Background:
- Hallux rigidus is typically associated with arthritic changes in the first metatarsophalangeal (MTP) joint.
- Rheumatoid arthritis (RA) can affect the MTP joint, often leading to pain and stiffness.
Observation:
- Loss of motion at the first MTP joint was observed in RA patients, even without hallux valgus or joint destruction.
- A hyperextension deformity of the interphalangeal joint, with associated painful callus, was also noted.
Findings:
- The first MTP joint appeared normal on roentgenograms, and passive motion was clinically normal.
- The observed loss of MTP motion was functional, attributed to intrinsic great toe muscle spasm to offload lesser metatarsal heads.
- Interphalangeal hyperextension may be a secondary development to this "functional hallux rigidus."
Implications:
- This suggests a distinct presentation of hallux rigidus in RA, not solely reliant on structural joint damage.
- Understanding functional hallux rigidus is crucial for accurate diagnosis and targeted treatment in RA patients.
- Further research may explore the specific mechanisms of muscle spasm and its long-term effects on foot biomechanics.