Hallucal sesamoiditis manifested on bone scan

The first metatarsal articulation bears one third of the weight of the forefoot. The hallucal sesamoids are embedded in the flexor hallucis brevis and connected by the intersesamoid ligament and plantar plate. The sesamoid apparatus acts as a pulley to help pull the big toe down against the ground during walking. Repetitive pressure, force, or tension can cause sesamoiditis. If the impact is great enough, the bones can break. Here we present a woman with big toe pain during walking. Our case highlights the role of 99mTc-MDP bone scan in reaching the diagnosis of hallucal sesamoiditis.