What are the sesamoids of the foot?
There are two sesamoids in each foot, the Tibial and Fibular sesamoid. The sesamoid are located underneath your big toe joint forming the sesamoid apparatus. The sesamoids function as a pulley for tendons and allow leverage when the big toe pushes off the ground.
What is sesamoiditis?
Sesamoiditis is inflammation of the sesamoids due to injury from overuse with an increase in physical activity such as hiking or running. Patients with a high arch type are prone to developing sesamoiditis.
How to diagnose sesamoiditis?
Sesamoiditis can be difficult to diagnose and has to be differentiated from patients with a turf toe injury or sesamoid fracture. Sesamoiditis is typically not associated with an acute traumatic event when the big toe is hyper extended. X-rays are taken to rule out a sesamoid fracture and sometimes an MRI is needed to help with the diagnosis. Patients with sesamoidits have localized pain and swelling underneath the 1st metatarsal head.
How to treat sesamoiditis?
Sesamoiditis is treated with immobilization in a controlled ankle motion boot or cast, NSAIDs/steroids, RICE, dancer’s pad, custom orthotics, and shoes with a rocker bottom sole. Rarely patients with sesamoiditis will require surgical intervention and may involve dorsiflexing the 1st metatarsal or sesamoidectomy.