Exams and Tests

A bunion (hallux valgus) is an enlargement of bone or tissue around the joint at the base of the big toe (metatarsophalangeal joint). If you have a bunion, you will notice a bump on your big toe joint. The big toe may turn toward the second toe (displacement), and the tissues surrounding the joint may be swollen and tender.

Bunions are diagnosed through a medical history and physical exam. This may include:

• Asking about your history of symptoms, including when they started, what activities or shoes make them worse, and whether other joints are painful.
• Examining your toe and joint and evaluating their range of motion. This is done while you are sitting and while you are standing, so that the toe and joint can be observed both at rest and while bearing weight.
• Checking your reflexes, pulse, and sensation, to rule out other problems.

Tests that may be done

X-rays are often used to find out the degree of bone deformity or to rule out other causes of pain and swelling. If surgery is being considered, X-rays can help your doctor determine what type of surgery will be most helpful in treating the symptoms. X-rays usually are done while you are standing so that the foot is bearing weight. In some cases, magnetic resonance imaging (MRI), computed tomography (CT scan), or bone scan are also used.

Further tests, such as blood tests or arthrocentesis (removal of fluid from a joint for analysis), are sometimes done if other conditions that can cause joint pain and swelling are suspected, such as gout, rheumatoid arthritis, or joint infection.