Case: Osteoarthritis first metatarsophalangeal joint

Hallux rigidus is a progressive disorder of the first MTP joint, characterized by a diminished range of motion (ROM) and degenerative alterations of the joint.

The main clinical presentation of osteoarthrosis of the first metatarsophalangeal joint is pain and joint impingement. Sometimes it is an active inflammatory arthropathy with pain and clinical swelling due to both the proliferative disease and the flexion of the first MTP joint.

Because of biomechanical disturbance or local pathology, the first metatarsophalangeal joint of the foot is the joint prone to degenerative joint diseases.

In this particular case, you can see a longitudinal grayscale ultrasound that shows the dorsal and the plantar aspect of the first metatarsal joint of the foot. The large dorsal marginal osteophytosis and the joint space narrowing are made visible. Dorsiflexion is limited because of this abutment of the articular surfaces of the phalanx and metatarsal head. At the plantar side of the right joint, you can see a small erosive degeneration with some fragments in the adjacent plantar plate. The capsular swelling is due to synovitis, synovial proliferation and effusion, there is no crystal deposition visible. Extension of the joint is painful with crepitus.

Figure 2. Longitudinal grayscale ultrasound image obtained over the plantar aspect of the first metatarsophalangeal joint with a small erosive degeneration and some fragments in the adjacent plantar plate.

Figure 3. Dorsoplantar radiograph with joint space narrowing of the first metatarsophalangeal joint with subchondral sclerosis and dorsal osteophyte formation.

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link to ultrasound #training: https://www.123sonography.com/msk-fa-launch