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Sunday, February 26, 2012

Bone Spur on the Big Toe Joint: Sign of Hallux Rigidus and Severe Arthritis

This middle aged gentleman appeared to my office with big toe joint pain and a large bump at the top of the big toe joint. This bump is called a "dorsal bunion" to distinguish it from the typical bunion on the side of your big toe.

Here is the side view of John's big toe joint with a very large bone spur which will need surgical removal since it is causing him great difficulty fitting shoes. The bigger the spur, normally the bigger the joint breakdown.

No surgeon would want to approach this without considering joint fusion. We will be getting an MRI to see if there is any normal joint surface worth trying to save. A total joint implant is probably the second best guess right now. Look at the other  view of the joint above.

Here the normal appearance of the joint looks distorted normally indicating a severe breakdown of the joint.  If you look at the bone of the first metatarsal where it hits the toe, it does not look well. 

As a conservative podiatrist, I will hope that the MRI shows some chance of saving this joint from a fusion, but not a first glance. 


  1. I have a very large hard boney growth at the base of my big toe, where the toe meets the foot, on the top of the toe. It looks even bigger when I bend my toes. It does not hurt at all. Also, on the same foot, I have another growth on the outside of my little toe, on the outside foot area. What can this be? Neither hurt...I am 65 years young...did martial arts years ago. Could this have affected my foot? The left foot, actually, is beginning to look the same, but much smaller growths. Could these growths be bone cancer? My husband says I souldn't worry, they are bunions. Ready to see a doctor, but wanted your opinion first. Thanks! Port K., Atlanta, GA

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.