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Sesamoiditis

By

Kendrick Alan Whitney

, DPM, Temple University School of Podiatric Medicine

Last full review/revision Dec 2019| Content last modified Dec 2019
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Sesamoiditis is pain around the two small bones (the sesamoid bones) below the metatarsal head where it adjoins the big toe (first metatarsal head).

  • Symptoms include pain when walking while wearing certain types of shoes.

  • The diagnosis is based on an examination of the foot.

  • Orthoses and new shoes can help relieve pain.

The cause of sesamoiditis is usually repeated injury. Sometimes the bones are fractured (see Figure: Where Foot Fractures Occur Where Foot Fractures Occur Fractures of the foot include toe fractures and fractures of the middle bones of the foot (metatarsal fractures), the two small round bones at the base of the big toe (sesamoid fractures), or... read more ), or the bones or surrounding tissues are inflamed. A change in the structure of the foot can sometimes shift the position of the sesamoids (displacement) and cause pain.

Sesamoiditis is particularly common among dancers, joggers, and people who have high-arched feet or frequently wear high heels. Many people with bunions Bunion In bunion, the joint at the base of the big toe appears to stick out (becomes prominent). Abnormalities in joint position or motion can distort and enlarge or seem to enlarge the joint that... read more Bunion have sesamoiditis.

Symptoms of Sesamoiditis

The pain of sesamoiditis is felt beneath the base of the big toe (the first metatarsal joint). The pain is usually made worse by walking, particularly when wearing certain flexible thin-soled or high-heeled shoes. The area may be warm and swollen, and the big toe may be red.

Diagnosis of Sesamoiditis

Treatment of Sesamoiditis

  • New shoes

  • Orthoses

Not wearing the shoes that cause pain may be sufficient. If symptoms continue, however, shoes with a thick sole, low heels, orthoses (devices placed in the shoe), or a combination help by reducing pressure on the sesamoid bones.

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Reactive Arthritis
Reactive arthritis causes inflammation of the joints and the tendon attachments at the joints. It is called “reactive” because it frequently occurs in reaction to an infection. In which of the following organs is such an infection most likely to occur? 
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