Purpose: The purpose of this study was to evaluate the radiographic characteristics and structural configurations of a series of patients with a primary degenerative arthritis of the second metatarsophalangeal joint.
Methods: We studied 37 feet that had undergone surgical treatment for primary degenerative arthritis of the second metatarsophalangeal joint. The patients were compared with a randomly selected control group, without arthritis of the second metatarsophalangeal joint. The first, second, and fourth metatarsal lengths, and the size of the second metatarsal head were measured on weight-bearing anteroposterior radiographs. The patients were classified on the basis of joint-space narrowing, subchondral sclerosis, osteophyte formation, and subchondral cystic change.
Results: The average second metatarsal length was significantly longer in the study group (P = 0.01). The average length of the first metatarsal relative to the fourth metatarsal was significantly shorter (P = 0.02) in the study group, while the average length of the second metatarsal relative to the fourth metatarsal was significantly longer (P = 0.01) in the study group. The average diameter of the second metatarsal head was significantly larger in the study group (P = 0.00), and the average ratio of this diameter relative to the length of the fourth metatarsal was significantly higher in the study group (P = 0.00). A total of four feet were classified as grade 0, nine as grade 1, 17 as grade 2, and seven as grade 3.
Conclusions: Second toe rigidus should be considered as a diagnosis in patients with painful limited dorsiflexion of the second metatarsophalangeal joint without evidence of Freiberg's infraction or trauma.