Pain and/or inflammation (with minimal or no radiographic change) of one or both of the two sesamoid bones embedded in the flexor hallucis brevis tendon under the 1st metatarsophalangeal (MTP) joint
Etiology and Pathophysiology
- Pain results from repetitive, increased forefoot weight-bearing stresses or forceful dorsiflexion of the great toe.
- May also be caused by fracture, stress fracture, infection, inflammatory arthropathies, congenital deformity to the sesamoid(s), and osteoarthritis in the absence of repetitive trauma
No known genetic predisposition
- Athletes who repetitively put significant load on the sesamoids are at particular risk, such as the following:
- Long-distance runners
- Ballet dancers
- Baseball catchers
- Acquired peroneal dysfunction/tightness
- Abnormal first ray range of motion
- Decreased 1st MTP motion (hallux limitus/rigidus)
- Congenital factors increase the risk of injury.
- Asymmetry in the size of the sesamoid bones
- Malalignment of the sesamoid bones
- Supinated or pronated foot type
- Forefoot valgus, plantar flexed first ray
- Decreased ankle dorsiflexion
- Cavus feet (high arch)
Sesamoiditis is most commonly an overuse injury; activity modification is key to prevention.
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Domino, Frank J., et al., editors. "Sesamoiditis." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688618/all/Sesamoiditis.
Sesamoiditis. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688618/all/Sesamoiditis. Accessed June 10, 2023.
Sesamoiditis. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688618/all/Sesamoiditis
Sesamoiditis [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 10]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688618/all/Sesamoiditis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Sesamoiditis ID - 1688618 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688618/all/Sesamoiditis PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -