Diagnosing Bunions

Doctors at NYU Langone diagnose bunions by examining your foot. This condition causes the big toe to turn toward the second toe. As a result of this change in bone structure, a hard, bony bump forms at the base of the big toe where a joint connects the toe to the foot.

Misalignment in the bones of the foot caused by a bunion may also cause metatarsalgia, the painful swelling of the ball of the foot. It can also lead to the development of a neuroma, which is inflammation in a nerve that travels between the bones of the feet and toes.

If a bunion is severe and the big toe overlaps the second toe, fitting your foot into a standard size shoe may become difficult and painful. Early diagnosis by our orthopedic surgeons and podiatrists can ensure that treatment begins before this can occur.

Medical History

Doctors may ask questions about when you first noticed a bunion, whether you experience foot or toe pain, whether you've had a bunion before on one or both feet, and whether anyone else in your family has had them. In addition, doctors may ask about the kind of shoes you usually wear and whether you have a job that requires you to be on your feet for long periods of time.

Physical Exam

A physical examination of the foot is often all that’s needed for doctors to confirm a diagnosis. In addition to examining the big toe for changes in the bone structure, doctors gently move the toe to determine if a bunion restricts the range of motion or causes pain, numbness, or tingling in the toe or foot.

Doctors may also ask you to walk a few steps to see how the body’s weight is distributed across your foot and toes.

X-ray

If a bunion causes significant pain or severely changes the shape of the big toe, doctors may recommend X-ray imaging. An X-ray of the foot reveals how far the big toe joint has moved away from the other toes and whether any other bones in the foot or toes have been affected.

Ultrasound

If your symptoms include tingling or numbness in the foot, and your doctor suspects inflammation in the nerves running between the bones of the feet and toes, he or she may recommend ultrasound imaging.

Ultrasound uses high-frequency sound waves that bounce off of soft tissue inside the body, capturing the returning “echoes” as images.

MRI Scan

Your doctor may recommend an MRI scan if he or she suspects that changes in the bone structure of the foot may have led to other types of damage. For example, if excess stress is put on the toes during movement, a tiny fracture called a stress fracture may develop. MRI can also reveal inflammation in the nerves in the feet and toes.

MRI uses a magnetic field and radio waves to create computer-generated two- and three-dimensional images of soft tissues within the body.