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Figure 1. Anteroposterior view of right foot
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Figure 2. Lateral view of foot.
A 42-year-old woman presents with pain over the lateral aspect of her right foot that has been present for several months. She reports the presence of a bump on the lateral side of the foot that is sore to the touch after a day of walking or exercise. On physical examination, the patient has soft-tissue swelling under the fifth metatarsal head and a prominent lateral eminence of the fifth metatarsophalangeal (MTP) joint. She has pain with passive motion at the fifth MTP joint. Radiographs are taken (Figures 1 and 2).
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The patient is diagnosed with a bunionette deformity, also known as a tailor’s bunion, that is characterized by a prominence of the lateral aspect of the fifth metatarsal head.1 Bunionettes are often seen in adolescents and adults and are more common in females.2 The deformity results from compression of the forefoot and can lead to forefoot pain and callus formation over the prominence.1
Nonoperative management is the first line of treatment of bunionette deformities and includes nonsteroidal anti-inflammatory drugs (NSAIDS), modifications of shoe wear to increase the toe box, as well as the use of semi-rigid soles, orthotics, keratosis padding, and/or callous shaving.1-3 Nonoperative treatment is generally successful, but should symptoms become persistent and severe, surgical options are available including a lateral condylectomy and osteotomy procedures.1-3
References
1. Shi GG, Humayun A, Whalen JL, Kitaoka HB. Management of bunionette deformity. J Am Acad Orthop Surg. 2018;26(19):e396-e404. doi:10.5435/JAAOS-D-17-00345
2. Bunions:Overview. Informed Health.org. June 28, 2018; updated 2021. Accessed August 14, 2023. https://www.ncbi.nlm.nih.gov/books/NBK513134/#:~:text=Bunions
3. Koti M, Maffulli N. Bunionette. J Bone Joint Surg Am. 2001;83(7):1076-1082. doi:10.2106/00004623-200107000-00016
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