HV

Hallux valgusClinical

A deformity where the big toe angles inward toward the second toe.

What it is

Hallux valgus is a progressive structural deformity at the first metatarsophalangeal joint, where the big toe drifts laterally while the first metatarsal deviates medially, producing the characteristic bunion prominence. It is a bony and soft-tissue realignment, not simply a soft-tissue swelling, and it tends to worsen gradually over years rather than resolve.

Why it matters

The degree of deformity shapes footwear tolerance, pain with push-off, and forefoot load distribution, which in turn affects gait pattern and balance, particularly in older adults. Recognising HV early informs conversations about footwear modification, orthotic or padding strategies, and realistic expectations about whether conservative management can slow progression or whether the presentation warrants orthopaedic referral.

How it's measured

Clinically it is assessed by observing hallux and metatarsal alignment, joint mobility, presence of overlying bursitis or skin changes, and any secondary lesser toe deformity or transfer metatarsalgia. Radiographic weight-bearing views allow measurement of the hallux valgus angle and intermetatarsal angle, which grade severity and guide decisions around surgical referral, though clinical function and symptoms should be weighed alongside these angles rather than radiographs alone.

Watch-outs

Radiographic angle alone does not reliably predict pain or disability, so imaging severity and patient-reported limitation can diverge. Because aetiology is multifactorial and debated, avoid attributing the deformity to a single cause such as footwear or attributing correction to bracing or toe spacers, as these do not reverse established bony deformity.

Sources & further reading
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This guide was auto-drafted and is pending editorial review.