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Persistent Seseimoiditis

Posted by jenelle f on 5/02/03 at 09:23 (117652)

I have had persistent pain and joint limitation in my toe for 2 years. The first podiatrist said it was a bunion and did surgery, but the pain persisted and the joint limitation increased. I never did have a visible bunion. The second podiatrist diagnosed plantar fibromatosis and hallux rigidus. I was prescribed a rigid orthotic with a toe extension and was told there was a surgical option--fusion of my toe joint, etc. The podiatrist I now see has diagnosed chronic seseimoiditis and says I have a sharp point on it and it is larger than normal and odd looking. After several months and 4 injections (they helped for awhile then pain returned), he has suggested surgery as the best option. I also have burning pain in my ankle/calf. I am confused by the differing diagnoses and the prognosis. As it stands, the pain is quite limiting and increases in direct proportion to my activity level. My questions are: Help in understanding the differing diagnoses--who do I trust?; what are reasonable expectations for pain reduction and increased mobility in a situation like this. I am 52 years old, if that helps. Thanks so much.

Re: Persistent Seseimoiditis

Dr.Biehler on 5/02/03 at 13:41 (117682)

I do not get time to view this board very often, but I thiught I might give you some information on your question. If a person has a tight achilles tendon, this can prevent them from being able to have their tibia rock over their foot when walking. To compensate, the person usually has an early heel lift at this point of his gate. This shifts his weight forward and can cause the foot to pronate. When this happens it can cause the first MPJ to lock up.Over time this can become permanate and you develop hallux rgidus. When the first MPJ locks up, most people tend to roll off the medial side of the first metatarsal head and the hallus. This excess weight can cause the sessimoid to become inflamed and eventually become hypertrophied. It sounds like you are being diagnosed, one part of the problem at a time.

Re: Holy Cow! It's Dr. B!!!!

Richard, C.Ped on 5/02/03 at 15:07 (117690)

Long time no see Dr. B! Welcome back!

Re: Holy Cow! It's Dr. B!!!!

jenelle f on 5/02/03 at 17:21 (117698)

Thanks Dr. B. I'm amazed at this message board--so many people in pain. You doc's are great to participate.