147 - Sesamoiditis

Abstract

Sesamoiditis is one of the most common pain syndromes that affect the forefoot. It is characterized by tenderness and pain over the metatarsal heads. Although the first sesamoid bone of the first metatarsal head is affected most commonly, the sesamoid bones of the second and fifth metatarsal heads also are subject to the development of sesamoiditis. The patient often feels that he or she is walking with a stone in his or her shoe. The pain of sesamoiditis worsens with prolonged standing or walking for long distances and is exacerbated by improperly fitting or padded shoes. Sesamoiditis is most often associated with pushing-off injuries during football or repetitive microtrauma from running or dancing. The sesamoid bones are small, rounded structures that are embedded in the flexor tendons of the foot, usually in close proximity to the joints. Sesamoid bones of the first metatarsal occur in almost all patients, with sesamoid bones being present in the flexor tendons of the second and fifth metatarsals in a significant number of patients. These sesamoid bones decrease friction and pressure of the flexor tendon as it passes in proximity to a joint.