Clinical Evaluation
Clinical assessment
It will confirm the diagnosis with an enlarged joint, and osteophytes sometimes palpable. Stiffness is quantified by the degree of mobility loss. Normal is 45° up and 45° down. There is often an asymmetry between toe mobilization, as the toe is more mobile downwards.
We can find in the interrogation, a «morning unwinding», as if the joint were rusty. the first morning walk is very difficult, but it improves after five minutes. Similarly, rest will decrease pain and prolonged standing or intense activity will increase it.
It will also be possible to assess whether the discomfort comes from the joint itself or from the back conflict associated with the shoe. The possible consequences on the other radius will be appreciated.
Imaging Evaluation
It will complement the examination with the practice of x-rays of both feet anteroposterior and profile, loaded, a scanner and if necessary an MRI.
On the x-rays we observe a disappearance of the cartilaginous space: the bones touch each other directly, and the presence of «parrot beaks» (osteophytes).
At a more advanced stage, bone densification is observed in relation to the joint, and bone holes.