30 year old dancer presents with complaint of not being able to flex or extend the big toe of the left foot. She also experiences pain and stiffness after walking or standing. Patient was involved in a head-on car collision about 2 years ago causing a fracture of her foot, ankle as well as her metatarsals. Her past medical history otherwise is non-contributory. She does not drink or smoke. She has tried Ayurvedic medicine with some success.
Discussion: The joint at the base of the big toe is called the metatarophalangeal joint, or MTP joint. This is the junction of small bone of the big toe and the long bone of the forefoot. This joint is essential to the biomechanics of our feet, receiving much stress and prone to arthritis by itself. Pain around the base of the big toe is a common symptom of arthritis around this area. This pain is exacerbated by activity. After the joint is fused by itself, the toe may not touch the ground, which may cause slight instability or imbalance when the patient walks.