Orthopedics - Oleksa A.P. 2006

Osteochondropathies
Osteochondropathies of the Bones of the Lower Extremity
Osteochondropathy of the Sesamoid Bones of the Metatarsophalangeal Joint

Osteochondropathy of the sesamoid BONES OF THE metatarsophalangeal joint, first described in 1925 by Renander and later by Smith, is a rare condition that is frequently underdiagnosed by clinicians. It typically occurs in patients with flat feet and presents as pain in the plantar region of the metatarsophalangeal joint during walking. The condition has an insidious and slow onset.

Physical examination reveals no pathological changes in this area; the metatarsophalangeal joint is not swollen, though signs of Hallux Valgus deformity may occasionally develop.

Radiographic examination is the most crucial diagnostic tool for sesamoid bone osteochondropathy. However, obtaining a projection that clearly displays these bones for proper evaluation is challenging, even with the aid of a magnifying Glass. Osteonecrosis is manifested by increased bone density.

Treatment involves joint offloading and The Use of arch Supports (orthotics) to elevate the FOOT arches and alleviate pain.

In almost all cases, the condition culminates in hallux valgus deformity due to an antalgic contraction of the m.abductor hallucis.



Last update: 10/08/2026

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