Is it a Bunion or Something Else?: How to Tell

"Is it a Bunion or Something Else?: How to Tell"

 

Many times, we will see a patient who is absolutely convinced they are suffering from pain related to a condition called a "bunion" deformity. Sometimes they are correct, other times we need to adjust this diagnosis.  Bunions typically are formed from biomechanical stresses which progress and lead to joint deviation and sometimes dislocation. This is accompanied by pain with motion and may lead to the need for surgery.

 

 

When the prominence is on TOP of the toe joint, it is not necessarily the same condition. We often refer to this as a "Dorsal bunion" or hallux limitus/rigidus. This is Latin for restriction of motion of the first toe joint. This is a very localized form of osteoarthritis and requires a different approach. Bunions tend to improve with padding and wider shoes. These sorts of issues are more likely to improve with coritsone injections and specific orthotics in the shoes. Other times it may require either a fusion, or an implant of the joint to maintain motion in specific cases. These are also progressive, and lead to limited motion and increased pain secondary to the arthritis in the joint space. We have a variety of holistic joint preservation techniques such as supplementation, PRP injections, and anti inflammatory cremes available to quell acute symptoms and maintain joint motion

 

This radiograph shows the excellent straight appearence of the toe joint, but also shows the absence of a joint space which can be an indication of severe degenerative joint disease (osteoarthritis). 

Observe the giant "lump" on top of this patients foot. Painful and inflamed this can be a source of debilitation and may require a cortisone injection for relief initially. 

 

 

One must be aware of the problem and it's nature, in order to obtain an excellent solution. Therefore, if there are any concerns or questions about what specifically is occurring in the foot and ankle, you should promptly be seen by your foot and ankle surgeon.

 

 

Brian Timm, DPM, AACFAS, DABLES
Board Certified by the American Board
of Lower Extremity Surgeons in
Reconstructive Foot and Ankle Surgery