M20.21

Clinical Causes: Joint cartilage deterioration due to arthritis Increased stress or strain on the toe joint from activities or footwear Repetitive trauma or injury to the toe joint Congenital deformities affecting foot structure Advanced age contributing to cartilage wear Previous foot injuries that damage joint surfaces

Key Symptoms: Pain in the big toe during movement or when bearing weight Stiffness and reduced flexibility in the toe joint Swelling or inflammation around the joint Pain that worsens with activity and improves with rest Difficulty in wearing certain footwear comfortably A feeling of crunching or grinding when moving the toe Restricted ability to bend or straighten the toe fully

Diagnosis Path: Healthcare professionals typically diagnose hallux rigidus through physical examination and patient history. They assess the range of motion of the big toe, look for swelling, tenderness, and joint deformities. Imaging tests like X-rays are essential to confirm the diagnosis, evaluate the extent of joint degeneration, and differentiate it from other foot conditions. X-ray images often show osteophyte formation (bone spurs), joint space narrowing, and cartilage loss around the big toe joint.

Treatment Protocols: Conservative measures to reduce symptoms such as footwear modifications (stiff-soled shoes, wider toe boxes) Orthotic devices or shoe inserts to support the foot and reduce joint stress Nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation Physical therapy to strengthen surrounding muscles and improve joint mobility Activities and exercises tailored to reduce strain on the toe Injections of corticosteroids to decrease inflammation in some cases Surgical interventions, such as joint fusion or joint removal (cheilectomy), when conservative treatments are ineffective