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. 2023 May 16;16(1):29.
doi: 10.1186/s13047-023-00628-w.

The assessment and management of sesamoiditis: a focus group study of podiatrists in Aotearoa New Zealand

Preeti Kaur  1 , Matthew R Carroll  1   2 , Sarah Stewart  3   4
Affiliations

The assessment and management of sesamoiditis: a focus group study of podiatrists in Aotearoa New Zealand

Preeti Kaur et al. J Foot Ankle Res. .

Abstract

Background: Sesamoiditis is a common inflammatory condition affecting the sesamoid bones at the plantar aspect of the first metatarsophalangeal joint (1MTPJ). However, there are currently no recommendations or clinical guidelines to support podiatrists in their assessment or management of sesamoiditis. The aim of this study was to explore the views of podiatrists in Aotearoa New Zealand on their approaches to the assessment and management of patients with sesamoiditis.

Methods: This qualitative study included focus group discussions with registered podiatrists. Focus groups took place online via Zoom and were guided by a detailed focus group question schedule. The questions were designed to encourage discussion around assessment approaches used in the diagnosis of sesamoiditis and the treatment tools used to manage patients with sesamoiditis. Focus groups were audio-recorded and transcribed verbatim. Reflexive thematic analysis was used to analyse the data.

Results: A total of 12 registered podiatrists participated in one of three focus groups. Four themes were constructed relating to the assessment of sesamoiditis: (1) obtaining a patient history; (2) recreating patient symptoms; (3) determining contributing biomechanical factors; and (4) ruling out differential diagnoses. Seven themes were constructed relating to the management of sesamoiditis: (1) consideration of patient factors; (2) patient education; (3) cushioning of the sesamoids to allow more comfortable weightbearing of the 1MTPJ; (4) pressure redistribution and offloading of the sesamoids; (5) immobilisation of the 1MTPJ and sesamoids; (6) facilitating efficient sagittal plane motion during gait; (7) referring to other health professionals to find different ways to treat or manage patient symptoms.

Conclusion: Podiatrists in Aotearoa New Zealand demonstrate an analytical approach in the assessment and management of patients with sesamoiditis based on their clinical experience and knowledge of lower limb anatomy. A range of assessment and management techniques are selected based on the practitioners personal preferences, as well as the patient's social factors, symptomology, and lower limb biomechanics.

Keywords: First metatarsophalangeal joint; Focus groups; Podiatry; Qualitative; Sesamoiditis.

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Conflict of interest statement

SS and MC are on the editorial board for the Journal of Foot and Ankle Research. PK declares no competing interests.

Figures

Fig. 1
Fig. 1
Themes representing podiatrists’ approach to the assessment of sesamoiditis
Fig. 2
Fig. 2
Themes representing podiatrists’ approach to the management of sesamoiditis
See this image and copyright information in PMC

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References

    1. de Oliveira Beraldo D, et al. Bilateral sesamoiditis as first manifestation of gout. Case Rep Orthop. 2020;2020:8890549. - PMC - PubMed
    1. Chou LB. Disorders of the first metatarsophalangeal joint: diagnosis of great-toe pain. Phys Sportsmed. 2000;28(7):32–45. doi: 10.3810/psm.2000.07.1075. - DOI - PubMed
    1. Lee S, et al. Evaluation of hallux alignment and functional outcome after isolated tibial sesamoidectomy. Foot Ankle Int. 2005;26(10):803–809. doi: 10.1177/107110070502601003. - DOI - PubMed
    1. Schweitzer ME, Karasick D. Disorders of the hallux sesamoid complex - MR features. Int Skeletal Soc. 1988;27:411–418. - PubMed
    1. York PJ, Wydra FB, Hunt KJ. Injuries to the great toe. Curr Rev Musculoskelet Med. 2017;10(1):104–112. doi: 10.1007/s12178-017-9390-y. - DOI - PMC - PubMed