Summary
- Inflammation of the joint capsule (synovial membrane) accompanied by increased production of synovial fluid causing swelling.
- Usually caused by overload from an associated deformity, poor foot function, inappropriate footwear (wrong size, tighter, narrower, increased heel).
- Rheumatoid arthritis and osteoarthritis are risk factors.
- Long-term inflammation without treatment can damage the joint capsule and result in rupture.
Diagnostic tips
- Pain under the central ball of the foot (directly under the joint).
- Inflammation around joint.
- Deformity of toe.
- Difficulty with walking.
- Stiffness in the joint.
- Neuroma-like symptoms if the nerve is irritated by the swelling.
Tests and Imaging
- Clinical examination and detailed history.
- X-ray torule out fractures or infections and evaluate extent of deformity and degree of arthritis within the joint.
- Bone scan can identify damage to the capsule.
- Ultrasound and MRI help to diagnose soft tissue problems.
Immediate Treatment
- Reduce activity.
- Advise appropriate shoes (size, fit).
- Advise on how to strap or splint the toes in a corrected position.
- Possible guided injection for inflammation and pain.
Possible Referral
- Refer to a podiatrist for footwear advice/modification, insoles or orthotics with deflective padding.
- Surgical opinion for underlying deformity.
