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First MTP Bursa

bursa subcutanea medialis articulationis metatarsophalangei primi

The first MTP bursa is a subcutaneous bursa overlying the medial aspect of the first metatarsal head. It develops in response to chronic pressure and friction from tight footwear against a prominent medial metatarsal head, most commonly in association with hallux valgus deformity. It is not present at birth and is considered an adventitial bursa.

Region: Foot & Ankle

Clinical Relevance

Clinical Notes

Often called the bunion bursa, this structure is the source of the redness, swelling, and tenderness that makes symptomatic hallux valgus immediately visible. It can become acutely inflamed, infected, or ulcerated. Treatment involves wide-toed footwear, protective padding, and bursectomy as part of hallux valgus surgical correction. In diabetic patients, infected bursal ulceration over a bunion can progress to osteomyelitis of the first metatarsal head.

Pathology

Common Injuries & Conditions

Bunion Bursitis

Acute or chronic inflammation of the first MTP bursa, producing pain, erythema, and swelling over the medial metatarsal head, often exacerbated by shoe pressure, managed with padding, anti-inflammatories, and footwear modification.

Infected Bursa

Particularly in diabetic or immunocompromised patients, the thin skin overlying the bursa can break down, allowing bacterial entry and producing septic bursitis or osteomyelitis requiring antibiotics and surgical debridement.