Foot issue
- Thread starter Laurs
- Start date
Again, from a total layman's view (who has seen these kinds of images and gone through 2 successful surgeries), the actual big toe halux valagus doesn't look too bad, which is circled in white, but that weird protrusion circled in red grabs attention. Looks like the joint of the big toe is clean, no spurs, no arthritis in there or anything. Your pain @Laurs is coming from the area between the big toe and second toe, is it not? Could it be from that 'blob' in between there? Dunno. Could a surgeon just clear that out of there?
Hi @jeff, thanks so much for paying such good attention 
, and yes, when i saw the X-rays for the first time at the consult with the first ortho, i also asked about that round protruding 'thing.' She then explained it was like a patella on the knee, i think it's called the sesamoid bone. And yes Jeff, the sensitive part is between toes 2 and 3. I have been doing some research and think it's a good idea to tell the ortho tomorrow that i have had psoriasis since i was a baby, my dad had it big time. I never had it bad, just elbows and knees when i was small, and scalp and big toe nails (half way only) when i was in my 30s. Though when i went completely gluten free, it all went away, more or less. I want to ask him if it's a good idea to explore if it could be psoriatic arthritis, i understand that there might be an indication from X-rays and MRI, and they can do further tests, blood and joint fluid, to confirm.
, and yes, when i saw the X-rays for the first time at the consult with the first ortho, i also asked about that round protruding 'thing.' She then explained it was like a patella on the knee, i think it's called the sesamoid bone. And yes Jeff, the sensitive part is between toes 2 and 3. I have been doing some research and think it's a good idea to tell the ortho tomorrow that i have had psoriasis since i was a baby, my dad had it big time. I never had it bad, just elbows and knees when i was small, and scalp and big toe nails (half way only) when i was in my 30s. Though when i went completely gluten free, it all went away, more or less. I want to ask him if it's a good idea to explore if it could be psoriatic arthritis, i understand that there might be an indication from X-rays and MRI, and they can do further tests, blood and joint fluid, to confirm.
Ok, the sensitive part is this marked in green?:
It looks like there is a lack of space between those toes, and maybe something attached to the bone (if only SRT could get rid of that!
)After reading Polly's horror story and reading other replies, I don't want to encourage surgical intervention right now either. Those injections plus DMSO sound very interesting albeit somewhat challenging in terms of procuring the proper needles and Quinton solution in addition to regularly poking your foot
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I think so, but I think the ortho said also the little piece in the proximal phalange bone underneath the spot you marked, which is almost touching the proximal phalange of toe 3. Yeah, no surgery at this point for sure and do all the necessary to get a definitive diagnosis, and of course I continue with the proper anti-inflammatory diet and keep on walking, swimming and yoga-ing. Luckily, the weather here is still excellent. Thanks Jeff!
The sesamoids are right where they belong, being part of a tendon system. What has happened is that the 1st metatarsal has gradually moved "inward". Instead of its head being centered over the sesamoids, it is now 'off-center', and severely so. That muscle/tendon system is now functioning like a bow string to reinforce and induce progression of the deformity. The only fix for this is surgery to restore the metatarsal position. That doesn't mean that you need to have surgery, only that surgery is the only possible way to correct the issue. This is an extremely common finding. Most people get on well with this problem.
The deformity is cause by many years of over-pronation while walking.
It looks to me like you may have some instability in the area of the Navicular/1st cuneiform joint, but only a physical examination and gait analysis would tell for sure. If so, this would very definitely contribute to over-pronation.
Are you having any symptoms in front of your ankle? It looks like your anterior tibial plafond may be under some stress.
Here's an image with correctly aligned sesamoids:
Understand that feet are as unique as faces. As far as bunions (Hallux Valgus) being hereditary, I've never heard of a gene coding for this. What is inherited are osseous shapes and alignment patterns that predispose one to developing such a deformity.
The deformity is cause by many years of over-pronation while walking.
It looks to me like you may have some instability in the area of the Navicular/1st cuneiform joint, but only a physical examination and gait analysis would tell for sure. If so, this would very definitely contribute to over-pronation.
Are you having any symptoms in front of your ankle? It looks like your anterior tibial plafond may be under some stress.
Here's an image with correctly aligned sesamoids:
Understand that feet are as unique as faces. As far as bunions (Hallux Valgus) being hereditary, I've never heard of a gene coding for this. What is inherited are osseous shapes and alignment patterns that predispose one to developing such a deformity.
Thank you very much @Yupo for your analysis, it helps a lot to explore what more i can do. When you say 'Most people get on well with this problem,' do you mean they get on well without the surgery? I don't have any problems in front of my ankle, yet, but from what you write and from what i just read about over-pronation, it would seem that looking into my gait, or at least have a video gait analysis, would be a first step now. I was thinking that this over-pronation may also cause, at least some, of my regular knee pain (which I've had for 26 years already). So, I'll see what the ortho has to say this afternoon, and do some research for a good podiatrist. Once again, many thanks for taking the time and effort to help me, I'm very grateful!