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.



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]


Weightbearing dorsoplantar and lateral projections.[1]


  • 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)


  • 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


  1. 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.
  2. 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.


  1. 1.0 1.1 1.2 1.3 1.4 1.5 Anthony Watson. Hammertoe Deformity Workup. Medscape. Updated: Nov 01, 2018