Painful sesamoid of the great toe  

作　　者：Alex L Sims Harish V Kurup 

机构地区：[1]Department of Orthopaedics, University Hospital of North Tees, Cleveland TS19 8PE, United Kingdom [2]Department of Orthopaedics, Pilgrim Hospital Sibsey Rd, Lincolnshire PE21 9QS, United Kingdom

出　　处：《World Journal of Orthopedics》2014年第2期146-150,共5页世界骨科杂志（英文版）

摘　　要：The painful sesamoid can be a chronic and disabling problem and isolating the cause can be far from straightforward. There are a number of forefoot pathologies that can present similarly to sesmoid pathologies and likewise identifying the particular cause of sesamoid pain can be challenging. Modern imaging techniques can be helpful. This article reviews the anatomy,development and morphological variability present in the sesamoids of the great toe. We review evidence on approach to history, diagnosis and investigation of sesamoid pain. Differential diagnoses and management strategies, including conservative and operative are outlined. Our recommendations are that early consideration of magnetic resonance imaging and discussion with a specialist musculoskeletal radiologist may help to identify a cause of pain accurately and quickly. Conservative measures should be first line in most cases.Where fracture and avascular necrosis can be ruled out,injection under fluoroscopic guidance may help to avoid operative intervention.The painful sesamoid can be a chronic and disabling problem and isolating the cause can be far from straightforward. There are a number of forefoot pathologies that can present similarly to sesmoid pathologies and likewise identifying the particular cause of sesamoid pain can be challenging. Modern imaging techniques can be helpful. This article reviews the anatomy,development and morphological variability present in the sesamoids of the great toe. We review evidence on approach to history, diagnosis and investigation of sesamoid pain. Differential diagnoses and management strategies, including conservative and operative are outlined. Our recommendations are that early consideration of magnetic resonance imaging and discussion with a specialist musculoskeletal radiologist may help to identify a cause of pain accurately and quickly. Conservative measures should be first line in most cases.Where fracture and avascular necrosis can be ruled out,injection under fluoroscopic guidance may help to avoid operative intervention.

关 键 词：SESAMOID PAIN GREAT TOE Management FOREFOOT 

分 类 号：R681.8[医药卫生—骨科学]