Thursday, March 16, 2017
Big Toe Joint Pain: MRI showing Plantar Plate Involvement
This is one of my blog patients (and yes, that is what I call you in my brain as I compartmentalize things). He has been suffering with big toe joint pain, presumably sesamoid, but probably more plantar plate tear. The arrow points to part of the plantar plate in front of the sesamoids by the toes. Some calm down by themselves with sesamoid off weighting, and limited push off for a while. Some remain chronically sore and need surgery to fix the instability created by the tear. Typically, you know what a surgeon will tell you. Read all you can about sesamoid management--off weight the big toe joint, limit the dorsiflexion of the joint, calm the inflammation down (all the white stuff in the image), create a pain free environment. Also, look at my reference on plantar plate testing.