Doctors at NYU Langone diagnose hammertoe by examining your feet to confirm that a toe is bent at the middle joint and the muscles are contracted, causing the end of the toe to point downward. Hammertoe may affect more than one toe on the same foot—for example, the second and third toes—and this condition may develop on one or both feet.
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Often, your doctor can confirm the diagnosis in a physical exam. If hammertoe has caused a significant change in the bone structure of your toes or foot, or if your symptoms suggest that there may be nerve irritation, called a neuroma, he or she may recommend diagnostic imaging.
Details about your symptoms and lifestyle can help a doctor diagnose hammertoe. The doctor may ask when you first noticed a bend in one or more of your toes and whether you experience any toe or foot pain, numbness, or tingling. He or she may also ask if one or both feet are affected and whether anyone else in your family has hammertoe. In addition, the doctor wants to know what kind of shoes you wear and whether you have a job that requires you to be on your feet for long periods of time.
A physical examination of the foot is often all that’s needed for your doctor to diagnose hammertoe. He or she visually assesses the extent of changes in the shape of your toes and confirms the presence of corns, which are hard lumps that may form on or between toes, or calluses, areas of thickened skin that may develop as a result of hammertoe.
A doctor gently moves the affected toe to determine whether the condition restricts range of motion or causes any pain or tingling in the toe or foot. He or she may also ask you to walk a few steps. This helps the doctor to verify if hammertoe affects the way your body’s weight is distributed across your foot and toes.
If hammertoe causes significant pain or has severely changed the shape of the foot, your doctor may recommend X-ray imaging. An X-ray of the foot reveals changes in the position of the toes and the extent of the structural changes in the foot caused by hammertoe.
If your symptoms include tingling or numbness and your doctor suspects that a neuroma, or nerve irritation, may be the cause, he or she may recommend ultrasound imaging. Ultrasound uses high-frequency sound waves that bounce off of soft tissue inside the body and capture the returning “echoes” as images. An ultrasound image can reveal areas of inflammation in the nerves running in between the bones of the feet and toes, indicating a neuroma.
If a doctor suspects that changes in the structure of the foot caused by chronic hammertoe have led to other types of damage—for example, a tiny break in a bone of the foot, called a stress fracture—he or she may recommend an MRI scan. MRI scans can also provide detailed images of nerves in the foot and may be used to confirm the presence of a neuroma. MRI uses a magnetic field and radio waves to generate two- and three-dimensional images of soft tissues within the body.
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