title: Avascular necrosis of the hallucal sesamoids update with reference to two case-reports.
abstract: We report two cases of nontraumatic metatarsal pain with sclerosis and fragmentation of the lateral sesamoid bone on roentgenographs and computed tomography images. One patient underwent magnetic resonance imaging (MRI), which showed low signal from the sesamoid bone. These imaging findings suggested osteonecrosis. Histology of the sesamoidectomy specimen confirmed this diagnosis in one patient. Avascular necrosis of the metatarsal sesamoid is an uncommon disorder. The suggestive roentgenographic and MRI findings rule out the other painful conditions of the sesamoid bone. The features are reviewed and the treatment options discussed.
authors.affiliation: Rheumatology department, CHU Hôpital Jean-Minjoz, boulevard Fleming, 25030 Besançon, cedex, France. eric.toussirot@ufc-chu.univ-fcomte.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Toussirot
authors.forename: Laurent
authors.initials: L
authors.lastname: Jeunet
authors.forename: Fabrice
authors.initials: F
authors.lastname: Michel
authors.forename: Bernadette
authors.initials: B
authors.lastname: Kantelip
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
mesh_terms: D000328:Adult; D003446:Crutches; D005260:Female; D006214:Hallux; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D012716:Sesamoid Bones / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed