Open Sesamoid: Medial Forefoot Pain In A Soccer Player - Page #1

Author: Luci Olewinski, MD
Co Author #1: Morteza Khodaee, MD, MPH.
Editor: Yaowen Hu, MD, MBA

Patient Presentation:
29 year old man presents with left medial forefoot pain.

29 year old man presents with left medial forefoot pain. He is an avid soccer player. Approximately one week prior to presentation, he struck his foot against the ground while running during a soccer game and immediately felt pain to the left plantar medial forefoot. He presents in a walking boot requesting further evaluation.
He has past history of left ACL repair but no previous injury to the left foot.

Physical Exam:
-Height: 60, Weight 204 lbs., BMI 27.6 kg/m2
-Left foot: Neutral alignment of foot with normal longitudinal arch. Intact sensation and less than 2 seconds capillary refill to all toes. Mild swelling across forefoot with notable tenderness to palpation along the medial and plantar aspect of the first metatarsophalangeal joint. Pain is worsened by dorsiflexion of first toe more so than plantar flexion.

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