Hallux Abductovalgus

The bunion can make the foot wider, making the footwear tighter. Tight fitting footwear will cause rubbing and friction over the bunion causing the skin to become red and swollen. In some cases the skin can thicken or even blister. A small fluid filled sack called a bursa may develop over the bunion which can be inflamed, swollen and painful. The severity of the pain will depend on how much pressure there is from your footwear. A bursa develops as a means of protection and shock absorption to a particular area that is having a lot of stress and pressure applied to it.

Patient Signs and Symptoms

Family History
Progressively painful 1st metatarsophalangeal joint/deformity
Aggravated by footwear

Significant Findings

Medial prominence of 1st MTP joint
Medial bursitis -Lateral deviation of Hallux
Abnormal 1st MTP joint ROM
Possible abnormal 1st ray with instability
Possible neuropathic pain
Wide forefoot
Narrow shoes
Positive grind test
2nd Digit Hammer toe with pre dislocation/ plantar plate pain
Plantar callous
Central Plantar metatarsalgia
Pronated foot type
Ankle equinis
Osteoarthritic changes
Ulceration in high risk groups
Family history links
Female predisposition

Imaging

Not indicated at initial assessment unless history of trauma or to suspect osteomyelitis, however x-ray has low sensitivity and specificity for detecting acute osteomyelitis.

Diagnosis made by clinical signs as typically indicates accurate diagnosis.

Imaging maybe used at later date, can be discussed at our MSK Podiatry Virtual Escalation clinic as required on presentation.

Preferably weight bearing views in lateral, Dorsal/ Plantar and Oblique.

Common presentation on X-ray are: