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MTP Synovitis (Capsulitis)
What is MTP Synovitis (Capsulitis)?
MTP Synovitis (Capsulitis) Defined
MTP synovitis is an inflammation of the metatarsophalangeal (or MTP) joint synovial lining. These joints are located at
the base of the toes and experience a significant amount of pressure with
normal gait. MTP synovitis is associated
with subsequent deformity of the affected toe, and can lead to dorsal
dislocation of the toe. The 2nd MTP, the joint next to the great
toe, is the most commonly affected MTP joint.
MTP Synovitis (Capsulitis) Symptoms and Anatomy
MTP synovitis is typically described as
a burning or aching pain at the joint. The pain is typically made worse when
walking without shoes on hard ground or flooring. The symptoms tend to be more
pronounced after prolonged periods of walking and at the end of the day. The synovial lining is in close proximity to
stabilizing ligaments on either side and the bottom of the joint. Consequently,
as the synovitis progresses, these neighboring structures can become stretched
and even begin to fail. Persons with an
elongated 2nd metatarsal place additional pressure and stress on
these structures, and is an important determination to make regarding your
MTP Synovitis (Capsulitis) Treatment Options
The primary goal of treatment is to
provide pain relief and maintain alignment of the toe. There are toe braces
called Budin splints which can be helpful at minimizing excess motion and
symptoms, when worn. There are also
metatarsal pad inserts which can be worn inside shoes to minimize pressure on
the ball of the foot. Stiff sole shoes and sandals can also help to minimize
pain at the ball of the foot. However,
if shoes and inserts are ineffective, surgery may be recommended.
MTP Synovitis (Capsulitis) Surgery
Surgery is reserved for patients who
have persistent pain and deformity of the toe despite non-surgical measures. If
the metatarsal bone is elongated, then a bone shortening procedure can be
performed to relieve the stress at the MTP joint. If there is deformity of the
toe, then collateral ligaments and/or the planter ligaments may need to be
repaired surgically. This typically involves an incision on top of the affected
joint. After surgery, the patient can
typically bear weight on the foot with a post-operative shoe or short walker
boot. Please consult your orthopaedic foot and ankle surgeon if you believe you
have MTP synovitis.