Type your tag names separated by a space and hit enter

Bunion (Hallux Valgus)

Bunion (Hallux Valgus) is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or purchase a subscription.

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

Medicine Central

-- The first section of this topic is shown below --



  • Lateral deviation of the great toe (Hallux abducto valgus derives from the Latin for “big toe askew.”)
  • Associated with medial deviation of the 1st metatarsal, leading to a medial prominence of the 1st metatarsophalangeal (MTP) joint (also known as “Bunion”); progressive subluxation of the 1st MTP joint is common.
  • System(s) affected: musculoskeletal/skin


  • Predominant age: more common in adults
    • Estimated 23% in adults aged 18 to 65 years
    • Estimated 35.7% in elderly >65 years
  • Predominant sex: female > male by ~2:1

  • Prevalence increases with age particularly in females.
  • Juvenile hallux valgus
    • More common in girls (>80% of cases)
  • Commonly bilateral
  • Pain is not usually the presenting symptom.

Etiology and Pathophysiology

Multifactorial. Contributing factors include the following:

  • Valgus deviation of the hallux promotes varus position of the 1st metatarsal.
  • Medial MTP joint capsule stretches and attenuates, whereas the lateral capsule contracts.
  • Metatarsal head moves medially, shifting the sesamoid bones to a more lateral position.
  • Extensor hallucis longus deviates laterally.
  • Lateral and plantar migration of abductor hallucis moves the great toe into plantar flexion and lateral pronation.
  • Medial collateral ligament stretches and eventually ruptures due to this deviation, decreasing stability and causing progressive subluxation of the 1st MTP joint.

Risk Factors

  • Familial predisposition
  • Abnormal biomechanics (i.e., flexible flat feet)
  • Joint laxity; pronation of hindfoot; Achilles tendon contracture; pes planus (fallen arches)
  • Metatarsus primus varus
  • Amputation of second toe
  • Inflammatory joint disease
  • Neuromuscular disorders
  • Improper footwear, narrow toe box

General Prevention

Proper footwear may decrease the progression of the disease.

Commonly Associated Conditions

  • Medial bursitis of the 1st MTP joint (most common)
  • Hammertoe deformity of the 2nd phalanx
  • Plantar callus
  • Metatarsalgia
  • Degeneration of 1st metatarsal head cartilage
  • Pronated feet; ankle equinus
  • Onychocryptosis (ingrown toenail)
  • Entrapment of the medial dorsal cutaneous nerve
  • Synovitis of the MTP joint

-- To view the remaining sections of this topic, please or purchase a subscription --


Stephens, Mark B., et al., editors. "Bunion (Hallux Valgus)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816517/all/Bunion__Hallux_Valgus_.
Bunion (Hallux Valgus). 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/816517/all/Bunion__Hallux_Valgus_. Accessed April 20, 2019.
Bunion (Hallux Valgus). (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/816517/all/Bunion__Hallux_Valgus_
Bunion (Hallux Valgus) [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 20]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816517/all/Bunion__Hallux_Valgus_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bunion (Hallux Valgus) ID - 816517 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/816517/all/Bunion__Hallux_Valgus_ PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -