English

Abstract

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