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Evaluating the Function of the Foot Core System in the Elderly

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Hallux sesamoid complex imaging: a practical diagnostic approach.

Charles Lombard¹, Romain Gillet², Aymeric Rauch²

¹Service d'imagerie Guilloz, hôpital central, CHRU de Nancy, 29 avenue du Maréchal-de-Lattre-de-Tassigny, 54035, Nancy Cedex, France. charleslombard@hotmail.com.

Skeletal Radiology

|June 26, 2020

Summary

Pathologies of the hallux sesamoid complex cause foot pain. This review covers key anatomy, diverse conditions, and proposes a multimodality imaging approach for accurate diagnosis and patient management.

Keywords:

Avascular necrosis Diagnostic algorithm Fracture Hallux sesamoid complex Sesamoiditis Turf toe

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Last Updated: Dec 17, 2025

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Published on: March 11, 2022

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Area of Science:

Orthopedics
Radiology
Podiatry

Background:

The hallux sesamoid complex is susceptible to various pathologies, including trauma, degeneration, and inflammation.
Symptoms are often nonspecific, primarily manifesting as pain under the first metatarsal head.
Accurate diagnosis is crucial for effective patient management.

Purpose of the Study:

To review the complex anatomy of the hallux sesamoid complex.
To delineate the spectrum of pathologies affecting this region.
To propose a practical multimodality imaging approach for diagnosis.

Main Methods:

Review of anatomical key points of the hallux sesamoid complex.
Classification of pathologies into intrinsic and extrinsic anomalies.
Discussion of imaging modalities for diagnosis.

Main Results:

Hallux sesamoid pathologies encompass a wide range of conditions.
Intrinsic anomalies originate within the sesamoid bone, while extrinsic anomalies involve secondary involvement.
"Sesamoiditis" remains poorly defined in current literature.

Conclusions:

Understanding the complex anatomy is essential for diagnosing hallux sesamoid pathologies.
A systematic, multimodality imaging approach aids in differentiating intrinsic and extrinsic conditions.
Further clarification of entities like "sesamoiditis" is needed.