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bunion
A localized swelling at the medial or dorsal aspect of the 1st metatarsophalangeal joint generally associated with hallux valgus.
Etiology:
1) ill fitting shoes
2) ballet dancing
3) long-distance running
4) hallux valgus
Epidemiology:
- more common in women
Pathology:
- inflammed bursa
Genetics:
- family history in 3-5%
Clinical manifestations:
1) a medial bunion is generally associated with hallux valgus
2) callus or bursitis over the bony prominence
Radiology:
1) plain x-ray if surgical correction is considered
- radiographic evidence of a large angle between the proximal phalanx & the first metatarsal head
Differential diagnosis:
1) Rheumatoid arthritis
2) Gout
3) Pseudogout
4) Bursitis
5) Tendonitis
6) Tenosynovitis
7) Fibrositis
8) Degenerative joint disease
9) Traumatic joint injury
Management:
1) more appropriate footwear
- little evidence conservative measures including orthosis or more appropriate footwear effective [2]
2) also see hallux valgus
2) surgery if conservative measures fail (bunionectomy)
Specific
tailors's bunion
General
joint disease; articular disease; arthropathy
foot deformity
References
- Stedman's Medical Dictionary 27th ed, Williams &
Wilkins, Baltimore, 1999
- Geriatric Review Syllabus, 7th edition
Parada JT et al (eds)
American Geriatrics Society, 2010
- Geriatric Review Syllabus, 11th edition (GRS11)
Harper GM, Lyons WL, Potter JF (eds)
American Geriatrics Society, 2022