X-ray of hammer toe
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Author:
Mikael Häggström [notes 1]
A hammer toe or contracted toe is a flexion deformity of the proximal interphalangeal (PIP) joint of the second, third, or fourth toe, causing it to be permanently bent.
Planning
Indications
Imaging is not necessary for clinical diagnosis.[1] Its main uses are in detecting any alternative or synchronous diagnoses, as well as surgical planning.[1]
Procedure
Weightbearing dorsoplantar and lateral projections.[1]
Evaluation
- Look at joints for erosions, suggesting arthritis.[1]
- Look at the metatarsophalangeal (MTP) joints for any varus angulation and/or dorsal subluxation or widening of the joint sace, suggesting MTP instability.[1]
- Detect any bunion[1] (see X-ray of bunion)
Also look at the metatarsal heads, particularly for enlargemet and osteophytes, suggesting Freiberg disease (pictured)
Measure the flexion angles of suspected involved toes only if requested by the referral. This case is a normal foot, with flexion angle of the second toe PIP joint.
Report
- Flexed PIP joints and in which toes.[notes 2]
- Give angles in numbers only if the degree of deformity is requested by the referral, since it is not a reliable basis for diagnosis.
- Absence or presence of other deformities.
- See also: General notes on reporting
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
- ↑ Do not use the term "hammer toe" in the report, because X-ray can not distinguish physiologic flexion from deformities in the muscles and ligaments around the tendon.
