Hallux Rigidus

​Hallux rigidus is arthritis of the big toe joint. It is the most common arthritic condition of the foot and second only to hallux valgus (bunion) as a condition associated with the big toe. Females are more commonly affected than males in all age groups, and the condition typically develops in adults between the ages of 30 and 60 years.​

Symptoms and Clinical Presentation

Most patients present with a complaint of pain in the big toe joint while active, especially when pushing off to walk. Others note swelling and stiffness around the big toe joint or an inability to bend the toe up or down. A bump, like a bunion or bone spur, can develop on top of the big toe joint and be aggravated by rubbing against the inside of a shoe.

Cause (including risk factors)

The true cause of hallux rigidus is not known. However, several risks factors have been identified and include an abnormally long or elevated first foot bone (metatarsal), differences in foot anatomy, prior traumatic injury to the big toe, and family history. Most of these risk factors cause damage to the surfaces of the bone and lead to wear and tear of the joint, which in turn leads to arthritis.

Anatomy
​The big toe joint connects the head of the first foot bone (metatarsal) with the base of the first toe bone (proximal phalanx) and the two tiny bones (sesamoids) underneath the head of the first foot bone (metatarsal). This big toe joint is called the hallux metatarsal phalangeal or MTP joint.

Diagnosis

​In many cases, the diagnosis of hallux rigidus can be made by a physician on physical examination alone. He or she will examine the foot for evidence of bone spurs and check the MTP joint by moving it up and down to see how much motion is available without pain. X-rays may be performed to help understand the extent of joint degeneration and to show the location and size of bone spurs.

 

*Source:  American Orthopaedic Foot & Ankle Society® http://www.aofas.org