Sesamoid problems
What is a sesamoid problem?
Inflammation of the sesamoid, often called sesamoiditis, is typically an overuse injury of the sesamoid bones in the ball of the foot underneath the big toe. These bones may become inflamed and create pain in the ball of the foot.
What causes a sesamoid problem?
Sesamoiditis can be caused by trauma to the sesamoid bones, or as a repetitive use injury, sometimes seen in long distance runners, sprinters, ballet dancers. A lack of blood supply to the sesamoids can cause a condition of inflammation and fragmentation called osteonecrosis.
What are the symptoms of a sesamoid problem?
Patients with sesamoiditis typically have pain in the ball of the foot that is aggravated by movement, pressure, walking and running.
How is a sesamoid problem diagnosed?
Sesamoiditis is diagnosed by thorough history and physical examination. X-rays are typically ordered to assess for any abnormality of the sesamoid bones. Sometimes MRI and/or CT scans may be ordered to better evaluate the sesamoid bones.
How is a sesamoid problem treated?
Nonsurgical treatment
Conservative treatment for sesamoiditis is typically very successful for the majority of patients. The main goal is to relieve pressure on the sesamoids and diminish repetitive loading through the painful area. This is often achieved with rest, use of a cast or walking boot, ice, activity modification, anti-inflammatory medications, metatarsal pads, comfort shoes with a low heel and wide toe box, calf stretching, orthotics, cortisone injections and occasionally walking boots.
Operative treatment
Operative treatment can be necessary in patients who fail conservative therapy. The surgery involves removing the sesamoid bone, or in cases of fracture, repairing the fracture.