Skeletal Radiology

, Volume 21, Issue 7, pp 437–444 | Cite as

The hallux sesamoids revisited

  • Hollis G. Potter
  • Helene Pavlov
  • Tod G. Abrahams
Articles

Abstract

The hallux sesamoids are vulnerable to signifycant injury and weight-bearing stress in both the athlete and the nonathlete. Unfortunately, they are often dismissed as inconsequential accessory bones. The historical significance, embryology, anatomy, and physiology of the sesamoids and the salient features of both traumatic and nontraumatic pathologic conditions affecting these structures are presented. Because the sesamoids can be responsible for prolonged disabling foot pain and discomfort, it is important for both clinician and radiologist to pay attention to these bones and recognize the early signs of abnormality.

Key words

Sesamoids Magnetic resonance imaging 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Beltran J, Noto AM, McGhee RB, et al. (1987) Infections of the musculoskeletal system: high-field strength MR imaging. Radiology 164:449Google Scholar
  2. 2.
    Bizarro AH (1921) On the traumatology of the sesamoid structures. Ann Surg 74:783Google Scholar
  3. 3.
    Bowers KD, Martin RB (1974) Impact absorption, new and old Astroturf at West Virginia University. Med Sci Sports 6:217Google Scholar
  4. 4.
    Bowers KD, Martin RB (1976) Turf-toe: a shoe-surface related football injury. Med Sci Sports 8:81Google Scholar
  5. 5.
    Brown TIS (1980) Avulsion fracture of the fibular sesamoid in association with dorsal dislocation of the metatorsophalangeal joint of the hallux: report of a case and review of the literature. Clin Orthop 149:229Google Scholar
  6. 6.
    Browne T, McCarron RF (1988) Pseudomonas osteomyelitis of the metatarsal sesamoid: a case report. Orthop Rev 17:601Google Scholar
  7. 7.
    Calabro JJ (1962) A critical evaluation of the diagnostic features of the feet in rheumatoid arthritis. Arthritis Rheum 5:19Google Scholar
  8. 8.
    Capasso G, Maffulli N, Testa V (1990) Rupture of the intersesamoid ligament of a soccer player's foot. Foot Ankle 10:337Google Scholar
  9. 9.
    Chillag K, Grana WA (1985) Medial sesamoid stress fracture. Orthopedics 8:821Google Scholar
  10. 10.
    Clanton TO, Butler JE, Eggert A (1986) Injuries to the metatarsophalangeal joints in athletes. Foot Ankle 7:162Google Scholar
  11. 11.
    Coker TP, Arnold JA, Weber DL (1978) Traumatic lesions of the metatarsophalangeal joints of the great toe in athletes. Am J Sports Med 6:326Google Scholar
  12. 12.
    Colwill M (1969) Osteomyelitis of the metatarsal sesamoids. J Bone Joint Surg [Br] 51:464Google Scholar
  13. 13.
    Conway WF, Hayes CW, Murphy WA (1989) Case report 568: Total resorption of the lateral sesamoid secondary to Pseudomonas aeruginosa osteomyelitis. Skeletal Radiol 18:483Google Scholar
  14. 14.
    De Britto SR (1982) The first metatarso-sesamoid joint. Int Orthop 6:61Google Scholar
  15. 15.
    De Luca FN, Kenmore PI (1975) Bilateral dorsal dislocations of the metatarsophalangeal joints of the great toes with a loose body in one of the metatarsophalangeal joints. J Trauma 15:737Google Scholar
  16. 16.
    Erdman WA, Tamburro F, Jayson HT, et al. (1991) Osteomyelitis: characteristics and pitfalls of diagnosis with MR imaging. Radiology 180:533Google Scholar
  17. 17.
    Feldman F, Pochaczevsky R, Hecht H (1970) The case of the wandering sesamoid and other sesamoid afflictions. Radiology 96:275Google Scholar
  18. 18.
    Freund KG (1989) Haematogenous osteomyelitis of the first metatarsal sesamoid. Arch Orthop Trauma Surg 108:53Google Scholar
  19. 19.
    Giannikas AC, Papachristou G, Papavasiliou N, et al. (1975) Dorsal dislocation of the first metatarso-phalangeal joint. J Bone Joint Surg [Br] 57:384Google Scholar
  20. 20.
    Gold RH, Hawkins RA, Kate RD (1991) Bacterial osteomyelitis: findings on plain radiography, CT, MR, and scintigraphy. AJR 157:365Google Scholar
  21. 21.
    Gordon SL, Evans C, Greer RB (1974) Pseudomonas osteomyelitis of the metatarsal sesamoid of the great toe. Clin Orthop 99:188Google Scholar
  22. 22.
    Helal B (1981) The great toe sesamoid bones: the lus or lost souls of Ushaia. Clin Orthop 157:82Google Scholar
  23. 23.
    Hubay CA (1949) Sesamoid bones of the hands and feet. AJR 61:493Google Scholar
  24. 24.
    Ilfed FW, Rosen V (1972) Osteochondritis of the first metatarsal sesamoid. Clin Orthop 85:38Google Scholar
  25. 25.
    Inge GA, Ferguson AB (1933) Surgery of the sesamoid bones of the great toe. Arch Surg 27:466Google Scholar
  26. 26.
    Jahss MH (1981) The sesamoids of the hallux. Clin Orthop 157:88Google Scholar
  27. 27.
    Kewenter Y (1936) Die Sesambeine des 1. Metatarsophalangealgelenks des Menschen. Acta Orthop Scand [Suppl] 2:1Google Scholar
  28. 28.
    Kliman ME, Gross AE, Pritzker KP, et al. (1983) Osteochondritis of the hallux sesamoid bones. Foot Ankle 3:220Google Scholar
  29. 29.
    Kursunoglu S, Resnick D, Goergen T (1987) Traumatic dislocation with sesamoid entrapment in the interphalangeal joint of the great toe. J Trauma 27:959Google Scholar
  30. 30.
    Larcos G, Brown ML, Sutton RT (1991) Diagnosis of osteomyelitis of the foot in diabetic patients: value of 111In-leukocyte scintigraphy. AJR 157:527Google Scholar
  31. 31.
    Leonard MH (1960) The sesamoids of the great toe — the pedal polemic. Report of three cases. Clin Orthop 16:295Google Scholar
  32. 32.
    McBryde AM, Anderson RB (1988) Sesamoid foot problems in the athlete. Clin Sports Med 7:51Google Scholar
  33. 33.
    Ogata K, Sugioka Y, Urano Y, et al. (1986) Idiopathic osteonecrosis of the first metatarsal sesamoid. Skeletal Radiol 15:141Google Scholar
  34. 34.
    Resnick D, Niwayama G, Feinagold ML (1977) The sesamoid bones of the hands and feet: participators in arthritis. Radiology 123:57Google Scholar
  35. 35.
    Richardson EG (1987) Injuries to the hallucal sesamoids in the athlete. Foot Ankle 7:229Google Scholar
  36. 36.
    Rodeo SA, Warren RF, O'Brien SJ, et al. Sesamoid diastasis simulating turf-toe in professional football players: a report of four cases and review of the literature. Am J Sports Med (Submitted for publication)Google Scholar
  37. 37.
    Sammarco GJ, Miller EH (1982) Forefoot conditions in dancers (part II). Foot Ankle 3:93Google Scholar
  38. 38.
    Seabold JE, Flickinger FW, Kao SC, et al. (1990) Indium-111-leukocyte/technetium-99m-MDP bone and magnetic resonance imaging: difficulty of diagnosing osteomyelitis in patients with neuropathic osteoarthropathy. J Nucl Med 31:549Google Scholar
  39. 39.
    Stadalnik RC, Dublin AB (1975) Sesamoid periostitis in the thumb in Reiter's Syndrome. Case report. J Bone Joint Surg [Am] 57:279Google Scholar
  40. 40.
    Sutro CJ (1965) The big toe. Comparative anatomic and radiographic study of the metatarso-phalangeal articulation. Bull Hosp Joint Dis 26:141Google Scholar
  41. 41.
    Szucs R, Hurwitz J (1989) Traumatic subluxation of the interphalangeal joint of the hallux with interposition of the sesamoid bone (letter). AJR 152:652Google Scholar
  42. 42.
    Torgerson WB, Hammond G (1969) Osteomyelitis of the sesamoid bones of the first metatarsophalangeal joint. J Bone Joint Surg [Am] 51:1420Google Scholar
  43. 43.
    Van Hal ME, Keene JS, Lange TA, et al. (1982) Stress fractures of the great toe sesamoids. Am J Sports Med 10:122Google Scholar
  44. 44.
    Yuh WT, Corson JD, Baraniewski HM, et al. (1989) Osteomyelitis of the foot in diabetic patients: evaluation with plain film, 99mTc-MDP bone scintigraphy, and MR imaging. AJR 152:795Google Scholar
  45. 45.
    Zinman H, Keret D, Reis ND (1981) Fracture of the medial sesamoid bone of the hallux. J Trauma 21:581Google Scholar

Copyright information

© International Skeletal Society 1992

Authors and Affiliations

  • Hollis G. Potter
    • 1
    • 2
  • Helene Pavlov
    • 1
    • 2
  • Tod G. Abrahams
    • 3
  1. 1.Cornell University Medical CollegeNew YorkUSA
  2. 2.The Hospital for Special Surgery and New York HospitalNew YorkUSA
  3. 3.University of Vermont School of Medicine and Maine Medical CenterPortlandUSA

Personalised recommendations