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The pathogenesis of hallux rigidus
The Journal of Bone and Joint Surgery. British Volume
|February 1, 1978
Summary
Hallux rigidus involves specific cartilage damage on the metatarsal head, causing stiff big toes. This condition, often missed on X-rays, likely results from a traumatic injury.
Area of Science:
- Orthopedics
- Podiatry
- Sports Medicine
Background:
- Hallux rigidus is a common degenerative condition affecting the first metatarsophalangeal (MTP) joint.
- Limited understanding exists regarding the specific etiology and early radiological presentation of hallux rigidus.
- The characteristic clinical presentation includes pain and stiffness in the great toe.
Purpose of the Study:
- To describe the clinical, radiological, and pathological features of hallux rigidus.
- To identify the specific site and nature of chondral and osteochondral lesions.
- To elucidate the potential traumatic etiology and mechanism of injury.
Main Methods:
- Clinical examination of seven patients (nine affected toes).
- Radiological assessment including plain radiographs.
- Pathological examination of surgical specimens.
Main Results:
- Characteristic chondral and osteochondral lesions were identified at a specific site on the metatarsal head.
- These lesions correlated with the typical limitation of dorsiflexion and relatively unrestricted plantarflexion.
- Radiological detection was often hindered by the predominantly cartilaginous nature of early lesions and subsequent degenerative changes.
Conclusions:
- Hallux rigidus is characterized by specific lesions on the metatarsal head, likely of traumatic origin.
- Early cartilaginous lesions may be missed radiologically, leading to delayed diagnosis.
- Understanding the mechanism of injury is crucial for managing hallux rigidus.