Sesamoiditis

Overview and Facts about Sesamoiditis

Sesamoids are bones embedded in certain tendons found in several joints throughout the body. Sesamoiditis is a form of tendinitis in which the tendons surrounding sesamoids become irritated or inflamed. Two very small examples of sesamoids can be found near the big toe, and sesamoiditis develops most frequently in the foot.

Sesamoids play several important roles, including helping the big toe move normally and providing leverage when it pushes off during walking and running. Sesamoids also absorb the weight placed on the ball of the foot when walking, running and jumping.

Signs and Symptoms of Sesamoiditis

As with many other orthopaedic conditions, the most common symptom of sesamoiditis is pain. Pain typically develops gradually beneath the big toe joint and comes and goes; it usually occurs during certain activities or when wearing certain types of shoes, such as high heels. Other symptoms include:

• Swelling or bruising
• Difficulty and pain when bending and straightening the big toe

Causes and Risk Factors of Sesamoiditis

Sesamoiditis is most often caused by excess activity on the balls of the feet. Certain athletes, including baseball catchers, runners and ballet dancers, are more susceptible to developing this condition.

People with high foot arches also have an increased risk of experiencing sesamoiditis because of the extra pressure on certain areas of the feet, as do those who frequently wear high heels or poorly fitting shoes.

Tests and Diagnosis of Sesamoiditis

To make a proper diagnosis, a doctor will perform a physical examination of the foot, checking for tenderness at the sesamoid bones. They may manipulate the bones, ask the patient to bend and straighten the big toe or bend the big toe up toward the top of the foot to determine whether that action causes the pain to intensify.

The doctor typically uses X-rays to confirm a diagnosis and rule out a fracture. An X-ray of the other foot allows the doctor to compare the bone structure. If the X-rays appear normal, the physician may request a bone scan, which can provide details that do not always appear on an X-ray.