Hallux sesamoid complex imaging: a practical diagnostic approach

• Published in: Skeletal radiology Vol. 49; no. 12; pp. 1889 - 1901
• Main Authors: Lombard, Charles, Gillet, Romain, Rauch, Aymeric, Germain, Edouard, Dodin, Gauthier, Blum, Alain, Teixeira, Pedro Gondim
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2020; Springer; Springer Nature B.V
• Subjects: Anomalies; Bones; Diagnosis; Diagnostic imaging; Diagnostic systems; Etiology; Imaging; Inflammation; Medical diagnosis; Medical imaging; Medicine; Medicine & Public Health; Metatarsus; Nuclear Medicine; Orthopedics; Pathology; Radiology; Review Article; Signs and symptoms; Sesamoiditis; Avascular necrosis; Fracture; Hallux sesamoid complex; Diagnostic algorithm; Turf toe
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-020-03507-8

A wide variety of pathologies can affect the hallux sesamoid complex of the foot, including traumatic, micro traumatic, degenerative, inflammatory, vascular, infectious, and neoplastic conditions. Symptoms are quite nonspecific, mainly related to pain in the plantar surface of the first metatarsal head. In this context, imaging is important for the etiologic diagnosis of hallux sesamoid complex pathology with implications in patient management. The hallux sesamoid complex has a complex anatomy, and pathologic processes of this region are poorly known of radiologists. Besides, some entities such as “sesamoiditis” remain poorly defined in the literature. Schematically, conditions affecting sesamoids will be divided into two major groups: intrinsic anomalies (sesamoid bone being the center of the pathologic process) and extrinsic anomalies (diseases secondarily involving sesamoid bones). Thus, in this article, after a review of anatomical key points and pathologies affecting the hallux sesamoid complex, a practical multimodality approach for the diagnosis of hallux sesamoid pathologies will be proposed.