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Related Experiment Video

Updated: Oct 8, 2025

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Evaluation of Radiographic Features Including Metatarsus Primus Elevatus in Hallux Rigidus.

Helen Anwander1, Mohammad Alkhatatba2, Till Lerch3

  • 1Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|January 3, 2022
PubMed
Summary

Metatarsus primus elevatus (MPE) is linked to hallux rigidus. This study found higher first metatarsal elevation and MPE incidence in hallux rigidus patients, supporting an association. Measurement reliability was also confirmed.

Keywords:
hallux rigidusmetatarsus primus elevatusradiographic evaluation

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Area of Science:

  • Orthopedic Surgery
  • Radiographic Analysis
  • Foot and Ankle Biomechanics

Background:

  • The etiology of hallux rigidus is debated, particularly its association with metatarsus primus elevatus (MPE).
  • Understanding radiographic parameters is crucial for diagnosing and managing hallux rigidus.

Purpose of the Study:

  • To evaluate radiographic parameters, including first metatarsal elevation, in patients with hallux rigidus compared to a control group.
  • To investigate the relationship between MPE and hallux rigidus.

Main Methods:

  • Retrospective case-control study involving 50 feet (25 with hallux rigidus, 25 without).
  • Radiographic assessment of first metatarsal elevation, MPE diagnosis, and lateral 1 to 2 intermetatarsal angle.
  • Inter-observer reliability testing for first metatarsal elevation measurement.

Main Results:

  • Patients with hallux rigidus exhibited significantly greater first metatarsal elevation (8.3 mm vs 3.0 mm) compared to controls.
  • MPE was diagnosed in 60% of hallux rigidus patients versus 0% in controls (p < .001).
  • A higher lateral 1 to 2 intermetatarsal angle was observed in the hallux rigidus group (p < .001).

Conclusions:

  • Increased first metatarsal elevation and a higher incidence of MPE are associated with hallux rigidus.
  • These findings support the theory linking MPE and hallux rigidus.
  • First metatarsal elevation measurement demonstrated high reliability.