Photos and X-Rays of Bunion/HAV Deformities

Do you have a bunion?

Bunions, also known as hallux abducto valgus (HAV), are a common problem, especially among women. Treatment may be as simple as wearing wider shoes, but if the bunion is very painful and limits your activities, you might need surgery. If you think you might have a bunion, these pictures might help you decide. 

Bunion/HAV Left Foot

Bunion/HAV Left Foot
Photo © Terence Vanderheiden, D.P.M.

Notice the bump on the side of the foot near the base of the big toe? That's the bunion. Typically, bunions are red, swollen, and/or sore. Shoes sometimes cause and contribute to the problem, but heredity also plays a big role in the development of bunions. If you're having a lot of pain, there are home treatments and products that you can use to help.

Left Foot X-Ray of Bunion/HAV

Left Foot X-Ray of Bunion/HAV
Photo © Terence Vanderheiden, D.P.M.

See the large angle between the first and second metatarsals? The larger this angle is, the more severe the bunion deformity. This bunion could arise from genetic predisposition, poor choice of footwear, or even the development of arthritis. 

Doctors assess the relative severity of a bunion by measuring several angles of the bones within the big toe. In general, the angle should be less than 15 degrees between the big toe and the first metatarsal. If the angle is larger, you're likely to be diagnosed with a bunion.

Bunion/HAV Left Foot

Bunion/HAV Left Foot
Photo © Terence Vanderheiden, D.P.M.

Notice the redness on the side of the foot near the big toe joint. Because of the bump, this area gets a lot of pressure from shoes that are too tight. Bunions rarely appear without any other clinical problem. Because of the joint stress, your natural tendency to walk differently to minimize the pain, and the likelihood that your big toe is rubbing on the second one, you'll likely develop calluses as well. 

If you experience foot pain when you walk in loose, flat shoes, consider seeing your doctor or a podiatrist for a foot examination. 

X-Ray Right Foot With Bunion/HAV

X-Ray Right Foot With Bunion/HAV
Photo © Terence Vanderheiden, D.P.M.

The two small circular bones under the first metatarsal head (big toe area) are called sesamoids. When the sesamoids are not directly under the first metatarsal head, the big toe tends to drift more toward the second toe.

Although some bunions may be treated with rest and changes in footwear or behavior, more serious situations may require surgery. Surgeons can perform one or more of several dozen different types of surgical intervention. In general, the surgical treatment plan will depend on the severity of the bunion. 

If you do have surgery, the location (hospital or outpatient surgery center) and anesthesia (local, general, or spinal) will differ based on the specific intervention. What won't differ, however, is your recovery time: Expect to stay off your foot for three to 12 weeks.

Bunion/HAV Right Foot

Bunion/HAV Right Foot
Photo © Terence Vanderheiden, D.P.M.

Notice how the big toe turns and leans against the second toe? Habitual wearing of narrow, pointed shoes can contribute to this change in the foot's structure if you wear too-tight shoes over several years. Bunions are more common in women because of modern-day footwear styles, but some men's shoe styles can also contribute to bunions. However, although shoes may contribute to bunions, the underlying clinical cause is rooted in your family medical history.

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