Adventitial Bursitis Of The 1st Mtp Joint

Home
About Us
- - About Us
  - About AMSSM
  - FAMSSM Designation
  - Awards
  - Founders
  - Past Presidents
  - Board of Directors
  - Committees
  - Contact Us
  - Bylaws/Policy & Committee Handbooks
- - FAMSSM Applications
  - Application submission is now closed for the 2026 Class of AMSSM Fellows. New Fellows will be announced to the AMSSM membership after the first of the year and honored at the 2026 Annual Meeting.
    
    Applications for the FAMSSM Designation will be available on an annual basis. Please contact Ellen Glasgow with any questions regarding the FAMSSM application.
- - We Understand You

Communications
- - Communications
  - Collaborate.AMSSM.org
  - New Branding Campaign
  - AMSSM Member Marketing Toolkit
  - Journal Access
  - Publications/Position Statements
  - Press Releases
  - Brochures
  - Weekly Digests
- - Online AMSSM Community for Members
  - AMSSM Collaborate online community provides a forum for year-long connection, giving members the chance to have conversations, share resources and make connections with your peers.
- - AMSSM Informational Brochures
  - Find informational brochures about sports medicine physicians geared toward coaches, parents and other healthcare professionals.
Education
- - AMSSM Sports Medcasts
  - Find all current and past AMSSM Sports Medcast episodes in one convenient location.
- - AMSSM Fellow Online Lecture Series
  - The AMSSM National Fellow Online Lecture Series features talks from national experts on fundamental sports medicine topics pertinent to fellowship training and sports medicine board certification. Go to the collaborate.amssm.org site and view the available lectures in the Upcoming Events area.
Research
Advocacy
- - Legislative and Policy Issues
  - AMSSM is the go-to organization for legislative and policy issues related to sports medicine and athlete health and safety.
- - Legislation by State
  - AMSSM offers a variety of advocacy resources, including a map that tracks legislation important to sports medicine physicians.
Sports US
- - Sports Ultrasound Online Didactics
  - These 35 educational modules cover all of the didactic instructional session topics recommended for sports medicine fellows by the AMSSM.
- - Sports Ultrasound Committee
  - Find all the resources, materials and guidelines from the AMSSM Sports Ultrasound Committee
Patients
- - Need a Sports Medicine Physician?
  - FindADoc
- - SportsMedToday.com
  - Your comprehensive sports medicine resource for athletes, coaches and parents.
Additional Information
- - Additional Information
  - Sports Med Today
  - Journals
  - Weekly Digests
  - Store
  - Careers
  - Industry
Foundation

Adventitial Bursitis Of The 1st Mtp Joint

Authors, Editors, Case Information Author: David Ross, MD Affiliation: Ross Medical Group, Miami, Florida Co Author(s): Mehak Sharma, MD. Department of Internal Medicine, FIU Herbert Wertheim College of Medicine, Bruce W. Carter VA Medical Center, Miami, Florida. Jackson Memorial Hospital, Miami, Florida. Senior Editor: Carlton Covey, MD, MEd Clinical Vignette: A 58-year-old woman presented with forefoot pain and swelling localized to the plantar aspect of the first metatarsophalangeal joint. She reported a longstanding history of daily high heel use as well as increased load on her feet from a half marathon training program. On physical exam, there was edema noted under the first metatarsal of the left foot as well as tenderness to palpation of the soft tissue over sesamoid and 1st MTP joint on the plantar aspect of the foot. Type of Probe Used: 8-12 MHz Linear Transducer Unlabeled Short Axis View of the Medial Plantar Forefoot Unlabeled Short Axis view of the medial plantar forefoot. Labeled Short Axis View of the Medial Plantar Forefoot Labeled Short Axis view of the medial plantar forefoot, demonstrating adventitial bursitis overlying the medial and lateral sesamoids with the flexor hallucis longus (FHL) tendon visualized between the sesamoids. Unlabeled Long Axis View of the Plantar 1st MTP Joint Unlabeled Long Axis view of the plantar first metatarsophalangeal joint. Labeled Long Axis View of the Plantar Forefoot Labeled Long Axis view of the plantar first metatarsophalangeal joint demonstrating adventitial bursitis overlying the medial and lateral sesamoids with the intact flexor hallucis longus (FHL) tendon visualized in plane. Interpretation Image Interpretation: Hypoechoic fluid collection superficial to the sesamoid complex at the plantar aspect of the first metatarsophalangeal joint, consistent with an adventitial bursitis. The medial and lateral sesamoids are visualized as hyperechoic structures with posterior acoustic shadowing. The flexor hallucis longus (FHL) tendon is identified between the sesamoids with preserved fibrillar architecture and no evidence of discrete tear or tendinopathy. No sesamoid fragmentation is identified to suggest fracture. A Longitudinal view confirms intact FHL tendon, as well as rules out a first metatarsal phalangeal effusion and confirms adventitial bursitis of the subcutaneous tissue on the plantar aspect of the foot. Teaching Pearl: Adventitial bursitis can be an underrecognized cause of plantar forefoot pain and swelling, especially when the diagnosis may be anchored on osteoarthritis, stress fracture, sesamoiditis, or plantar plate injury. Ultrasound can show a hypoechoic or anechoic bursal collection in the plantar soft tissues overlying a pressure point, often superficial to the sesamoid complex. A focused ultrasound scan should correlate the bursa with callus, footwear pressure, and point tenderness. Conservative treatment usually emphasizes offloading the area, shoe modification, orthoses, activity adjustment, and modifying gait or training contributors. References: 1. Chen X, Zhou G, Xue H, Wang R, Bird S, Sun D, Cui L. High-resolution ultrasound of the forefoot and common pathologies. Diagnostics (Basel). 2022;12(7):1541. doi:10.3390/diagnostics12071541 2. Zidani H, Genah I, Lae M, Bousson V, Laredo JD. Adventitious bursitis in the plantar fat pad of forefoot presenting as a tumoral mass. J Radiol Case Rep. 2020;14(2):12-20. doi:10.3941/jrcr.v14i2.3711 3. Albano D, Bonifacini C, Zannoni S, et al. Plantar forefoot pain: ultrasound findings before and after treatment with custom-made foot orthoses. Radiol Med. 2021;126(7):963-970. doi:10.1007/s11547-021-01354-8
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

Back		Top

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

Website created by the computer geek

Authors, Editors, Case Information

Unlabeled Short Axis View of the Medial Plantar Forefoot

Labeled Short Axis View of the Medial Plantar Forefoot

Unlabeled Long Axis View of the Plantar 1st MTP Joint

Labeled Long Axis View of the Plantar Forefoot

Interpretation

UPCOMING EVENTS

FIND A SPORTS DOC