Subungual Exostosis - toe pain caused by a bony outgrowth under the nail
Welcome to the Docpods Podiatrists Review and today we'll be taking a look at a subungual exostosis and how this presents clinically. A subungual exostosis a bony outgrowth that usually occurs on the distal phalanges of the toe. Excessive pressure and trauma around the nail bed will cause the underlying bone tissue to hypertrophy.
The resulting bony outgrowth often pushes on the soft tissues in the nail of the toe which causes pain. Now, let's take a look at what a subungual exostosis looks like in a clinical setting. You can see here from the video that the underlying bony outgrowth has caused the soft tissue surrounding it to bulge out and rub against the shoe. This causes excess pressure on the tip of the bony outgrowth causing callusing and pain. A typical subungual exostosis would usually occur on the first toe, however, this one is obviously on the second toe. Now let's take a look at what this same toe looks like on an x-ray. On the medial oblique view you can see the bony outgrowth on the distal phalanges of the second toe distorting the surrounding soft tissues. This is also evident on the AP view of this toe.
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