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Sesamoiditis is a topic covered in the 5-Minute Clinical Consult.

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Painful 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

  • Inflammation results from repetitive, increased forefoot weight-bearing stresses or forceful dorsiflexion of the great toe.
  • May also be caused by infection, inflammatory arthropathies, and osteoarthritis in the absence of repetitive trauma

No known genetic predisposition

Risk Factors

  • 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
  • Decreased first ray range of motion
  • 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)

General Prevention

Sesamoiditis is most commonly an overuse injury; activity modification is key to prevention.

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Stephens, Mark B., et al., editors. "Sesamoiditis." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816033/all/Sesamoiditis.
Sesamoiditis. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816033/all/Sesamoiditis. Accessed March 26, 2019.
Sesamoiditis. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816033/all/Sesamoiditis
Sesamoiditis [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 March 26]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816033/all/Sesamoiditis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Sesamoiditis ID - 816033 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816033/all/Sesamoiditis PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -