Sesamoiditis is an inflammatory condition of the sesamoid bones which are located on the plantar (bottom) aspect of the first metatarsal phalangeal joint.
Sesamoiditis causes pain in the ball of the foot, especially on the inner (medial) side. The pain may be constant, or it may occur with or be aggravated by, movement of the big toe joint. It may be accompanied by swelling (edema) throughout the bottom (plantar aspect) of the forefoot.
The onset of sesamoiditis may be insidious or abrupt. An insidious onset would suggest an inflammatory condition of the joint between the articular surface of the sesamoid and the articular surface of the first metatarsal phalangeal joint. An abrupt onset would suggest a fracture of the sesamoid.
Regardless of onset, pain is typical specific to the bottom of the first metatarsal phalangeal joint. Occasionally the entire first metatarsal phalangeal joint may swell and become stiff. Pain is aggravated by long periods of standing, squatting and the use of higher heeled shoes.
X-ray findings in cases of sesamoiditis usually show an increased density of the affected sesamoid bone. When viewing an AP X-ray, the appearance of the bone would light up brighter indicating increased density of the bone consistent with inflammation.
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