Footnotes / Blog

What a sesamoid?

A sesamoid is a bone that in embedded in tendon or muscle. In the foot, there are two sesamoids present under the big toe joint.

Sesamoiditis

The sesamoids under the big toe joint can become inflamed. Pain can present gradually. It may be painful when you move the big toe up and down, or when you press on the ball of the foot under the big toe joint. There may or may not be swelling and bruising.

• A sesamoid fracture or stress fracture can also occur. In the case of a sesamoid fracture, a traumatic event takes place such as landing hardly on the big toe joint. With stress fractures of the sesamoids, a recurrent trauma to the bones can cause small breaks that become very painful. This is common with runners and dancers.

Diagnosis

During your visit to the office, a podiatrist will exam the painful area. They may try to find “pin point” area of pain. The doctor may also move the toe up and down to see if there is pain with range of motion of the joint.  Usually xrays will be taken to see if there is a fracture present. Sesamoid fractures can be difficult to detect, so other imaging modalities such as bone scans and MRI can be utilized.

Treatment

Treatment depends on the severity of the condition. Conservative options include padding the affected area, anti-inflammatory medication, short leg walking cast boot, and occasionally pain relieving steroid injections.

Conservative treatment will often be attempted for 6 months. However, surgical removal of the sesamoid is then usually the next step in treatment if the patient is still experiencing pain.

Sesamoiditis can be a difficult problem to deal with, if you think you are experiencing this type of pain, make an appointment with one of the doctors at Innovative Foot and Ankle. We have 4 locations in the northern New Jersey area. Our offices in Montclair, Little Ferry, Kenilworth and Bayonne all have licensed podiatrists that would be glad to help.