Bunion

Bunion
Other namesHallux abducto valgus, hallux valgus[1]
SpecialtyOrthopedics, podiatry
SymptomsProminent, red, and painful joint at the base of the big toe[2]
ComplicationsBursitis, arthritis[2]
Usual onsetGradual[2]
CausesUnclear[1]
Risk factorsWearing overly tight shoes, high-heeled shoes, family history, rheumatoid arthritis[2][3]
Diagnostic methodBased on symptoms, X-rays[2]
Differential diagnosisOsteoarthritis, Freiberg's disease, hallux rigidus, Morton's neuroma[4]
TreatmentProper shoes, orthotics, NSAIDs, surgery[2]
Frequency~23% of adults[1]

A bunion, also known as hallux valgus, is a deformity of the MTP joint connecting the big toe to the foot.[2] The big toe often bends towards the other toes and the joint becomes red and painful.[2] The onset of bunions is typically gradual.[2] Complications may include bursitis or arthritis.[2]

The exact cause is unclear.[1] Proposed factors include wearing overly tight shoes, high-heeled shoes, family history, and rheumatoid arthritis.[2][3] Diagnosis is generally based on symptoms and supported by X-rays.[2] A similar condition of the little toe is referred to as a bunionette.[2]

Treatment may include proper shoes, orthotics, or NSAIDs.[2] If this is not effective for improving symptoms, surgery may be performed.[2] It affects about 23% of adults.[1] Females are affected more often than males.[2] Usual age of onset is between 20 and 50 years old.[1] The condition also becomes more common with age.[1] It was first clearly described in 1870.[1] Archaeologists have identified a high incidence of bunions in skeletons from 14th- and 15th-century England, coinciding with a fashion for pointy shoes.[5][6]

  1. ^ a b c d e f g h Dayton, Paul D. (2017). Evidence-Based Bunion Surgery: A Critical Examination of Current and Emerging Concepts and Techniques. Springer. pp. 1–2. ISBN 9783319603155.
  2. ^ a b c d e f g h i j k l m n o p "Bunions". OrthoInfo - AAOS. February 2016. Retrieved 8 November 2017.
  3. ^ a b Barnish, MS; Barnish, J (13 January 2016). "High-heeled shoes and musculoskeletal injuries: a narrative systematic review". BMJ Open. 6 (1): e010053. doi:10.1136/bmjopen-2015-010053. PMC 4735171. PMID 26769789.
  4. ^ Ferri, Fred F. (2010). Ferri's Differential Diagnosis E-Book: A Practical Guide to the Differential Diagnosis of Symptoms, Signs, and Clinical Disorders. Elsevier Health Sciences. p. 323. ISBN 978-0323081634.
  5. ^ Dittmar, Jenna; Mitchell, Piers (11 June 2021). "Fashion for pointy shoes unleashed a wave of bunions in medieval England". The Conversation. Retrieved 2021-06-28.
  6. ^ Dittmar, Jenna M.; Mitchell, Piers D.; Cessford, Craig; Inskip, Sarah A.; Robb, John E. (2021-06-11). "Fancy shoes and painful feet: Hallux valgus and fracture risk in medieval Cambridge, England". International Journal of Paleopathology. 35: 90–100. doi:10.1016/j.ijpp.2021.04.012. ISSN 1879-9817. PMC 8631459. PMID 34120868.