A False Step in a Ballerina: A Rare Case of Osteonecrosis of Subhallucal Sesamoid Bone

Abstract

Subhallucal interphalangeal osteonecrosis is an uncommon cause of forefoot pain, and a rarely reported clinical entity, being often overlooked. Imaging, particularly computed tomography (CT) scan and magnetic resonance imaging (MRI) have an essential role in early and differential diagnosis and guiding for appropriate therapy. The first approach should be conservative, and surgical treatment should be considered when it proves ineffective. In this case report, we describe a rare case of hallucal interphalangeal osteonecrosis manifesting a long-term hallux discomfort, successfully managed through a conservative approach, and we discuss the role of imaging techniques in its diagnosis.