Sesamoiditis is charactherized with pain and tenderness on the sesamoid bones among the runners with pronated ankles and feet. Pain is felt in the first metatarsophalengeal joints area. Bearing weight on the foot and tiptoeing may aggravate pain. Physical examination relieves tenderness either both or one sesamoid plantar surface.
Diagnosis is suspected with the clinical history and physical examination. Plain AP-lateral and sesamoid view x-rays is used for evaluation. MRI is very useful in the differential diagnosis.
Treatment may be anti-imflammatory medicine and rest as well as foot or thesis to correct the pronation deformity. Orthotic treatment is useful in mild cases. Orthotic supports aim to prevent to direct pressure. Basically they are designed to either prevent the direct contact with the ground or alleviate the pressure.
If the pain becomes persistent and can not be overcome with conservative measures, then surgery may be planned as a last resort. Removal of the sesamoid bone is performed.
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