Epidemiology and imaging appearance of the normal Bi-/multipartite hallux sesamoid bone

Foot Ankle Int. 2015 Feb;36(2):197-202. doi: 10.1177/1071100714552484. Epub 2014 Sep 18.

Abstract

Background: Turf toe is a hyperextension injury of the hallux metatarsophalangeal joint that can be difficult to diagnose on physical examination and imaging. Diastasis of the bi- or multipartite sesamoid of the hallux has been implicated as 1 potential radiographic finding of turf toe injury, and when present may require operative management. However, the normal interval for the bi-/multipartite sesamoid has not yet been established.

Methods: A total of 671 foot radiograph series were reviewed in effort to quantify the dominant interval of the bi-/multipartite sesamoid bone with respect to potential influencing factors including right versus left foot, medial and/or lateral sesamoid involvement, patient age and gender, and weight versus non-weight-bearing radiograph technique.

Results: The prevalence of a bi-/multipartite hallux sesamoid was 14.3% in our population. The dominant sesamoid interval ranged from 0-2 mm, with an average of 0.79 mm.

Conclusion: We conclude that sesamoid diastasis should be considered, in the appropriate clinical setting, when the sesamoid interval is greater than 2 mm on a routine AP radiograph of the foot.

Level of evidence: Level III, comparative study.

Keywords: forefoot disorders; hallux disorders; sports; statistical analysis; trauma.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Athletic Injuries / diagnostic imaging
  • Athletic Injuries / epidemiology
  • Female
  • Hallux Valgus / diagnostic imaging*
  • Humans
  • Male
  • Metatarsophalangeal Joint / diagnostic imaging
  • Metatarsophalangeal Joint / injuries*
  • Middle Aged
  • Radiography
  • Range of Motion, Articular
  • Sesamoid Bones / anatomy & histology*
  • Sesamoid Bones / diagnostic imaging*
  • Weight-Bearing
  • Young Adult