Bone Related Conditions

Bunions

Bunions are located along the inside of the foot at the base of the big toe.  They are an inherited condition that can be aggravated by shoe wear and activity.  In general the 1st metatarsal bone (connects middle of foot to big toe) starts to drift towards the other foot.  As this happens the big toe drifts towards the other toes.  The metatarsal bone can become enlarged from chronic pressure from shoes and the skin and soft tissue overlying the bone becomes swollen and inflamed.  Over time arthritis may develop in the joint so that there is pain to bending the toe up and down, as with normal walking.  An x-ray is helpful in evaluating all the components of a bunion deformity.

Tailors Bunions (Bunionette)

This condition is similar to a bunion but occurs on the outside of the foot at the base of the little toe.  In this case the 5th metatarsal (connects the middle of the foot to the little toe) does not drift but rather has an inherited tendency to curve outside and down.  This can cause pressure against the shoe both on the side and bottom, causing pain and swelling.  X-rays are very helpful in diagnosing tailors bunions.

Fractures

Fractures can occur in any of the 26 bones of the foot.  Most are caused by an injury and can easily be detected by x-ray.  Some fractures are caused by overuse and are called stress fractures.  This occurs when more stress is put on a bone than it is able to handle, and usually over a period of time.  If you think of bending a piece of wire back and forth repeatedly until it breaks vs. cutting it suddenly with a wire cutter you will understand the difference.  Stress fractures often will not be visible on the initial x-ray and may require additional x-rays a week or so later, an MRI, or a bone scan to detect.  Many types of fractures can be managed without surgery but all suspected fractures of the foot should be evaluated by a podiatrist to ensure the best possible outcome.