The bump at the 1st MTPJ that is towards the top of the foot, or dorsal, is hallux limitus or rigidus. Rigidus is the term for end stage hallux limitus. In hallux limitus, there is arthritis at the 1st MTPJ, or the bones are end to end, wearing away the joint. X-rays are necessary to stage the condition. Radiographically, your physician may see dorsal bone spurs, obliteration of the joint, and a square 1st metatarsal head. Clinically, there is pain at the 1st MTPJ, and there may be clicking or crepitus of the joint upon motion. There may be less motion at the joint, usually there is 65 degrees of dorsiflexion and 40 degrees of plantarflexion, however in limitus or rigidus the motion may be limited to less than 35 degrees dorsiflexion and 35 degrees of plantarflexion. Conservative options include orthotics with a Morton’s extension, however many cases are surgical.
Options include a cheilectomy (removing the dorsal spur), implants, or fusion. Dr. Badri and Dr. Zhang will discuss the right option for the patient depending on their condition and preferences.