The great toe has a single interphalangeal joint (unlike the lesser toes which have two), at which the FHL inserts distally and the extensor hallucis longus inserts dorsally. Hallux IP joint sesamoids may develop within the FHL tendon at this level in some individuals. The IP joint is the site of mallet hallux (FHL contracture or FHL tendon calcification) in dancers.
Hallux IP joint arthritis from gout or degenerative changes produces great toe IP pain managed with padding and injection. IP arthrodesis is rarely required but provides reliable pain relief when needed.
Great toe IP joint degeneration or gout producing IP joint pain managed conservatively with padding and injection.
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