The extensor hallucis brevis is the medial component of the extensor digitorum brevis, sharing its calcaneal origin but inserting on the great toe proximal phalanx rather than the extensor hood. Its bulky muscle belly on the dorsal foot between the ankle and first MTP is often mistaken for a ganglion or mass. The EHB can produce a palpable mass when hypertrophied in runners.
Great toe MTP dorsiflexion assistance; distinguishes EHL tendon (which continues to IP joint) from EHB on the dorsal foot
EHB hypertrophy — from ankle dorsiflexion restriction forcing compensatory toe extension — can produce a soft dorsal foot swelling medially that is mistaken for a ganglion. MRI confirms normal muscle anatomy. Occasionally EHB transfer is used in hallux varus correction or as a small supplementary donor in foot reconstruction.
Dorsal foot soft tissue mass from EHB muscle hypertrophy in runners with ankle dorsiflexion restriction confirmed by MRI as normal muscle.
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