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Dorsal midfoot exostosis - midfoot pain

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • condition most commonly occurs in the over pronated foot but can occur in the supinated foot
  • exostosis (benign osteochondroma) most frequently seen is that at the base of the first metatarso-cuneiform joint - often incorporating the base of the second and intermediate cuneiform joints
  • patients complain of midfoot pain on weight-bearing; also complains of discomfort due to shoe abrasion
  • in the supinated foot, a dorsal exostosis may be seen around the naviculo-cuneiform and/or talo-navicular regions - again the biggest problem is shoe wear causing discomfort on weight bearing

Management:

  • early stages orthotics reduce excessive movement and reduces pain; may be used in conjunction with steroid injections directly into the joint (s) under radiographic guidance
  • if a large exostosis causes intractable and severe pain then surgical removal is indicated; an alternative is fusion of the joint

Reference:

  1. Rheumatic Disease in Practice (September 2001). The therapeutic scope of modern podiatry. Issue number 6, Arthritis Research Campaign.

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