Disorders of the Great Toe

Versions Compared


  • This line was added.
  • This line was removed.
  • Formatting was changed.


Patients with hallux valgus often have a positive family history. It is common for patients to have a first-degree relative who has had a bunion, flatfoot deformity, or significant clawing of their lesser toes. Wearing tight or ill-fitting shoes may contribute to symptoms related to the hallux valgus deformity, but the evidence on causality is not conclusive.  

The main risk factor for disorders of the sesamoid is having a higher arched foot. People with high arches that may be predisposed to sesamoiditis may be able to prevent this by wearing properly fitting shoes with shoe inserts that reduce the stress on the sesamoids.   Additionally, as sesamoiditis is often caused by increased intensity of exercise, predisposed individuals wishing to increase exercise regiments should do so slowly and ideally in less weight bearing activities such as swimming or biking. 

According to Childs, risk factors for turf toe include participating in athletics on artificial turf fields, playing certain sports that predispose to the injury (football, soccer, basketball, wrestling, dancing, tennis, and volleyball), foot pronation, increased toe box flexibility, flat foot, hallux degenerative joint disease, and prior first MTP joint injury (PMID:16900075).  Therefore, turf toe may be prevented by wearing shoes with a stiffer sole and limiting the amount of play on artificial turf fields.



Turf toe


Clinical skills for the diagnosis of disorders of the great toe include the ability to take a detailed but focused history and perform a thorough musculoskeletal examination.  More advanced skills include the ability to aspirate and/or inject joints (students should be able to aspirate easily accessible joints such as the knee under expert supervision), and to identify crystals in joint fluid (gout)Perform a thorough musculoskeletal history and physical. 

Identify pathology on radiographs.