The first metatarsophalangeal joint Surface Anatomy

Location

The first metatarsophalangeal joint is located at the base of the great toe.

Significance

The first metatarsophalangeal joint is the most common site of arthritis in the foot. Arthritis in this joint is know as hallux rigidus and presents as pain and stiffness, especially upon dorsiflexion. Osteophytes on the dorsum of the joint may be palpable or visible, and are usually tender to touch. Osteophytes may limit joint motion and can be irritated by footwear.

A lateral deviation of the first metatarsophalangeal joint is known as hallux valgus. This condition is often associated with a protrusion of the medial aspect of the first metatarsal head, also known as a bunion. A bunion is composed primarily of boney deposits and soft tissue thickening. Hallux valgus is seen much more frequently in females and has been associated with poorly fitting footwear. Hallux varus, a medial deviation of the metatarsophalangeal joint, is rare and can be a post surgical complication of fixing a hallux valgus.

Turf toe is a sprain of the first metatarsophalangeal joint that is commonly cause by hyperextension of the great toe. Symptoms include swelling, erythema, tenderness, and limited motion of the joint. A sprain can be caused by stretching the joint capsule, or a partial to complete tear of the metatarsophalangeal ligaments.

Severe tenderness, warmth, erythema, and swelling in the first metatarsophalangeal joint is a sign of gout or septic arthritis.