ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. Q74M20Article OverviewHallux rigidus
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
Hallux rigidus: description
Hallux rigidus is the second most common disorder of the big toe after hallux valgus. It usually arises because the joint wears out due to increased stress (arthrosis). The great toe (hallux) can then move only in pain and limited (limitus). If the disease progresses, the metatarsophalangeal joint may also completely stiffen (Hallux limitus).
Hallux rigidus often occurs in the elderly. Although slightly more men are affected overall, women usually have earlier complaints because they often wear high heels.To the table of contents
Hallux rigidus: symptoms
Hallux rigidus usually affects only one foot. Initially, the short foot muscles may twitch more frequently. The big toe has a swelling and can be moved only limited and in pain up. Sometimes you can even hear that cartilage and bone pieces rub against each other (crepitus). Also, the appearance with the ball of the foot is painful, which is why the patient does not roll off the foot properly while walking. Instead, the foot is put on with the foot outside edge. Due to the altered gait, painful calluses may form on the outer edge of the foot. On the back of the foot may form over the big toe bony outgrowths, which are often painful.
In the course of the disease sometimes small joint body dissolve. If they get into the joint space, the joint can be blocked. As the hallux rigidus progresses, the metatarsophalangeal joint increasingly stiffens. Finally, the big toe can not be moved up or down.To the table of contents
Hallux rigidus: causes and risk factors
So far, it is not clear why a hallux rigidus develops. However, various factors are discussed that promote the joint wear (arthrosis) in the big toe and thereby promote this disease. These include:
- Shoesthat do not have the right foot shape
- foot shape: narrow, long feet, long big toe
- deformities like flatfoot, foot tilted inwards, deformity after paralysis
- Faulty or overloaded due to an abnormal gait or overweight
- Trauma: Injuries, fractures, inflammation, complications after foot surgery
- Metabolic or growth disorders
Osteoarthritis in the metatarsophalangeal joint narrows the joint space. The articular surfaces ossify and may become inflamed (synovitis). The partially swollen joint can only be moved under pain and restricted. As the hallux rigidus progresses, the joint space can be completely closed by remodeling. The joint is then completely stiffened.To the table of contents
Hallux rigidus: examinations and diagnosis
The doctor examines how mobile the metatarsophalangeal joint is. Pain, swelling and rubbing of bones and cartilage indicate a hallux rigidus. He also assesses the callus formation on the foot and the gait pattern. In the advanced stage of the disease, partial bone dislocations occur on the back of the toes. Their palpation causes pain to the patient. An X-ray does not provide evidence for Hallux rigidus until very late. The doctor can tell whether the joint space is narrowed and the articular surfaces are ossified.