Metatarsus primus elevatus and the etiology of hallux rigidus

One hundred twenty radiographs of the foot were evaluated for hallux abductus angle, lateral talometatarsal angle, and metatarsus primus elevatus position. Mean elevatus position of the first metatarsal above the second metatarsal was approximately 7.0 mm. First ray elevation was a consistent finding in all data groups studied, including controls. The presence of hallux abducto valgus or hallux rigidus did not affect the degree of first ray elevation present. The majority of radiographs studied lacked evidence of joint disease. Therefore, the common practice of evaluating radiographic elevatus as a surgical criteria to predict the possible development of hallux rigidus should be strongly discouraged.