Key Finding: Severe Hallux Valgus (Bunion Deformity)

• The hallux (big toe) is markedly deviated laterally at the first metatarsophalangeal (MTP) joint
• The first metatarsal is deviated medially (metatarsus primus varus), creating a wide intermetatarsal angle between the 1st and 2nd metatarsals
• The proximal phalanx of the great toe is severely subluxated/dislocated laterally off the first metatarsal head - they are no longer properly articulating

First MTP Joint

• Advanced osteoarthritis: severe joint space narrowing, subchondral sclerosis (whitening at bone margins), and osteophyte (bone spur) formation on both the metatarsal head and the base of the proximal phalanx
• The joint is essentially destroyed and dislocated in its chronic state
• The sesamoid bones beneath the first metatarsal head are displaced laterally, which is a classic secondary sign of severe hallux valgus

Lesser Toes

• The second toe is unusually long with a prominent proximal phalanx, and is crowded/deviated laterally due to the deformity of the great toe
• Third, fourth, and fifth toes show mild degenerative joint changes but remain relatively intact
• Mild joint space narrowing at the lesser MTP and interphalangeal joints

Midfoot / Tarsals

• The cuneiforms, cuboid, and navicular are visible in the hindfoot
• There is mild joint space narrowing and subchondral sclerosis at the tarsometatarsal (Lisfranc) and intercuneiform joints, consistent with mild midfoot osteoarthritis
• Mild diffuse osteopenia (reduced bone density) throughout, common in chronic joint conditions

Summary

Disclaimer: This is an educational image description only and does not constitute a medical diagnosis. Please consult an orthopaedic surgeon or podiatrist for clinical evaluation.