Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive deformity of the left first metatarsophalangeal (MTP) joint. Reports localized pain, tenderness over the medial eminence, and difficulty with footwear. Symptoms exacerbated by activity and prolonged standing. No history of acute trauma, infection, or inflammatory arthropathy.
Clinical Examination Findings
Left foot examination reveals a prominent medial eminence at the first MTP joint with hallux valgus deformity. First ray hypermobility noted. Second toe displays secondary clawing/overlapping. Skin over the bunion is erythematous with mild bursitis. Range of motion at the first MTP joint is restricted and painful at end-range. Neurovascular status intact.
Treatment Protocol
Conservative management initiated: recommendation for wide-toe-box footwear, orthotic inserts, and activity modification. NSAIDs prescribed for pain management. Referral for physical therapy to address intrinsic muscle strengthening. Discussion regarding surgical intervention (osteotomy/arthrodesis) if conservative measures fail to provide symptomatic relief.