Painful sesamoid of the great toe.

Autor: Sims AL; Alex L Sims, Department of Orthopaedics, University Hospital of North Tees, Cleveland TS19 8PE, United Kingdom., Kurup HV; Alex L Sims, Department of Orthopaedics, University Hospital of North Tees, Cleveland TS19 8PE, United Kingdom.
Jazyk: angličtina
Zdroj: World journal of orthopedics [World J Orthop] 2014 Apr 18; Vol. 5 (2), pp. 146-50. Date of Electronic Publication: 2014 Apr 18 (Print Publication: 2014).
DOI: 10.5312/wjo.v5.i2.146
Abstrakt: The painful sesamoid can be a chronic and disabling problem and isolating the cause can be far from straightforward. There are a number of forefoot pathologies that can present similarly to sesmoid pathologies and likewise identifying the particular cause of sesamoid pain can be challenging. Modern imaging techniques can be helpful. This article reviews the anatomy, development and morphological variability present in the sesamoids of the great toe. We review evidence on approach to history, diagnosis and investigation of sesamoid pain. Differential diagnoses and management strategies, including conservative and operative are outlined. Our recommendations are that early consideration of magnetic resonance imaging and discussion with a specialist musculoskeletal radiologist may help to identify a cause of pain accurately and quickly. Conservative measures should be first line in most cases. Where fracture and avascular necrosis can be ruled out, injection under fluoroscopic guidance may help to avoid operative intervention.
Databáze: MEDLINE