Rheumatoid arthritis in the feet: Metatarsal head subluxation

Chronic inflammation at the metatarsophalangeal (MTP) joints causes damage resulting in subluxation of the toes upwards. With the MTP joints displaced, weightbearing is not shared through the toes, but falls directly on the prominent metatarsal heads. This painful condition results in pain on weightbearing and difficulty in walking, and can cause the metatarsal to erode through the skin on the sole of the foot. Treatment in the early stages includes appropriate shoes and fitting of an orthotic that will support weight away from the painful metatarsal heads. Late-stage treatment may involve surgical excision of the prominent metatarsal heads.