Diagnostics
To diagnose arthritis of the metatarsophalangeal joint of the big toe, both a detailed anamnesis interview and a clinical examination are important. During the inspection of the metatarsophalangeal joint of the big toe, small lumps, the bony protrusions, are visible on the dorsal and medial side of the metatarsal bone. In addition, limited dorsal extension, i.e. stretching of the toes towards the back of the foot, can be tested in affected patients.
X-rays can be used as an imaging procedure to confirm the diagnosis. In this case, an image of the foot is taken in 2 planes under load. The X-ray image shows a joint narrowing as a result of cartilage wear and a changed bone pattern in the sense of extensions or small spur formations.
Treatment
Big toe metatarsophalangeal joint arthrosis can nowadays be treated very well with the different therapeutic approaches, so that the chances of recovery are very good both with conservative and surgical treatment. If left untreated, the situation in the metatarsophalangeal joint of the big toe gets worse and worse, but treatment can have a positive influence on its course. A previously unestablished therapy due to lack of success rates is the insertion of an endoprosthesis in the metatarsophalangeal joint of the big toe.
However, this type of treatment is currently being discussed more and more as it offers the clear advantage of avoiding joint stiffening. By inserting the endoprosthesis the main symptom pain can be relieved while maintaining mobility. Especially for women this variant becomes more and more attractive, because they can still wear high shoes without any problems. However, if the patient only moves the joint in moderation and does not plan to engage in strenuous sports activities, arthrodesis would still be more sensible.
