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Osteoarthritis of the hallux base joint: The base joint of the big toe frequently suffers from degeneration because it is exposed to a lot of physical strain (Fig. 8.72). Osteo-phytes and sclerosis of the periarticular bone point in this direction. Osteoarthritis may, however, become more aggressive (erosive osteoarthritis) and present with clinical signs of inflammation as well.

Rheumatoid arthritis (RA, see p. 147): Radiographic findings in RA of the foot resemble those in the hand (Fig. 8.73).

I Osteoarthritis (OA) of the Hallux Base Joint

Mtp Joint Podagra
Fig. 8.72 Osteophytes, synovial cysts (arrow), and sclerosis indicate degeneration (OA) of the first metatarsophalangeal joint.

Gout: Gout or gouty arthritis typically manifests itself in the first metatarsophalangeal joint. In this location it is also called podagra in fashionable Latin. In addition to the usual signs of arthritis, large defects develop in the vicinity of the joint (Fig. 8.74), the so-called gout tophi in which urates are deposited. The gout attack can simulate an otherwise unremarkable osteoarthritis, which is why in degenerative disease of the first metatarsophalan-geal joint a disturbance of the uric acid metabolism should always be excluded with the appropriate laboratory tests.

Hallux valgus: A hallux valgus is a pronounced lateral deviation of the great toe at its base joint. The angulation

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