The painful foot, Part I: Common forefoot deformities.

The incidence of forefoot pain and deformity increases with age. Metatarsal stress fracture may be diagnosed by palpating each metatarsal head. Clinical diagnosis of interdigital neuroma is made by applying top-to-bottom pressure to the suspected interspace with one hand while applying side-to-side pressure across the forefoot with the other hand. Clinical examination of patients with bunion reveals pain on palpation of the erythematous prominent metatarsal head. Features of hallux limitus include pain or crepitus and decreased motion of the first metatarsophalangeal joint. Hammer digit syndrome may be caused by excessive pronation, supination, neuromuscular deformities or systemic disease. Pain that occurs beneath the sesamoid apparatus with weight bearing or palpation may indicate sesamoiditis. With early diagnosis, conservative therapy is often successful in the treatment of common disorders of the forefoot.