Digital bursitis/Capsulitis

Dr Information

Summary – Inflammation in the joint capsule or bursa formation at the PIPJ, DIPJ or MTPJ.
Literature – Inflammation of the joint capsule, most commonly the plantar aspect of an MTPJ due to atrophy of plantar metatarsal fat pad or impact injury e.g running on concrete.
Diagnostic tip – isolate joint margin and apply direct pressure for pain response. Differentiate from plantar plate injury.
Testing or imagery – ultrasound imaging, rule out tear of capsule.
Referrals – referral to podiatrist for conservative management. If tear is identified offloading in a boot for minimum 6 weeks before surgical opinion.

Patient Information

Summary – Pain under the ball of the foot, getting worse with increased weight-bearing activity.
How does this occur? – Injury to the joint capsule, sometimes from repetitive strain e.g. running on concrete. More common when the ball of the foot is less padded with fat.
How can this be helped? – Increased padding in shoes, offloading provided by custom orthoses, imaging to rule out tear.
Who can help? – Your podiatrist, in cases of a tear, surgical opinion is required.