Lessor metatarsal sesamoiditis

NewsBot · Nov 21, 2014

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LESSER METATARSAL SESAMOIDITIS-POTENTIAL CAUSE OF FORE FOOT
PAIN?? : A PROSPECTIVE MULTICENTER EPIDEMIOLOGICAL SCREENING
STUDY OF THE ODISHA POPULATION
Sunil Kumar Dash,Geetanjali Arora, Ni**** Palo, Sidharth Singh Chaneel, Ashok Priyadarshi, Manas Ranjan Biswal
Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 62, November 17; Page: 13666-13673 (full text pdf)

INTRODUCTION: Sesamoiditis as a cause of fore foot pain is less often thought of,
patients suffer for extended periods due to misdiagnosis and analgesic abuse resulting in
dissatisfaction, depression and anxiety.
METHODS: We performed a multicenter prospective
epidemiological screening study in Bhubaneswar, Odisha from Nov’ 2013 to July’ 2014 in patients of
foot pain for the presence of lesser sesamoids to study the incidences and causes of fore foot pain in
Odisha Population.
RESULTS: We screened 960 patients (1920 feet) in 500 male and 460 female
patients. 5th Metatarsal sesamoids were present in 77 (8%) patients (M/F: 1.8:1), Bilateral in 67 (86
%) patients. (48%) patients lesser sesamoids were bipartite and (82%) were symptomatic. 52%
recovered with conservative measures, 40 % patients required ultrasound guided injections and
sesamoidectomy was performed in 8 % patients due to recurrence and/or failure. Other causes of
fore foot pain were Rheumatoid Arthritis, Gouty Arthritis, Callosities, Hallux Valgus, Stress Fractures
of the Metatarsals, Plantar Fasciitis, Infections, Morton’s Metatarsalgia and Barefoot Walking
(mechanical).
DISCUSSION: High incidences of lesser sesamoids is attributed to genetics, low
socioeconomic status, bare foot walking and high prevalence of Diabetes Mellitus, Smoking and Gout
in our country. CT and MRI provide useful information regarding the presence and pathology
involving these bones, and should be used in concert with clinical findings to guide successful patient
management. An initial trial of conservative measures should follow minimally invasive ultrasound
guided injections of anesthetic with steroids and lastly surgical excision.
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Admin2 · Nov 21, 2014

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