I had a patient today that we have found to be missing a medial sesamoid. I have never heard of this before, and was wondering if anyone out there has seen this previosuly.
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She presented with pain aound the medial sesamoid and tenderness with palpation around the medial/distal aspect of the right 1st metatarsal.
She has been referred to me by the sports dr and physio after they were not sure what to do. MRI has confirmed right abductor hallucis strain, inertmetatarsal bursitis (all IM spaces) and an absent medial sesamoid.
I am aware of the increased risk of HAV with this sesamoid being absent. I thought I'd post on here to see if there was anything else I should be looking out for now and in the future for this patient. She is a young (28yr old), athletic person competing in aust rules football and triathlon.
Already there is redcution of non-weight bearing 1st MPJ ROM to 20-25 degress of dorsiflexion. No HAV progress noted, 1st Ray position & stiffness and foot function are within normal limits.
Any info regarding this condition would be appreciated.
Scott
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