Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chief complaint of progressive pain and deformity at the right first metatarsophalangeal (MTP) joint. Symptoms include localized tenderness, swelling, and difficulty with footwear. Pain is exacerbated by prolonged standing and ambulation. No history of acute trauma, infection, or systemic inflammatory arthropathy.
Clinical Examination Findings
Physical examination of the right foot reveals a prominent medial eminence at the first MTP joint with lateral deviation of the hallux. Passive range of motion of the first MTP joint is restricted and painful. Skin overlying the bunion shows signs of chronic irritation/bursitis. No neurovascular deficits noted; distal pulses are palpable and capillary refill is less than 2 seconds.
Treatment Protocol
Initial management includes conservative measures: wide-toe box footwear, orthotic inserts, and activity modification. NSAIDs prescribed for pain and inflammation management. Referral for physical therapy to improve joint mobility. Surgical consultation discussed for potential bunionectomy if conservative measures fail to provide symptomatic relief.