Sesamoiditis

Sesamoiditis is inflammation of the sesamoid bones. In humans it occurs on the bottom of the foot, just behind the large toe. There are normally two sesamoid bones on each foot; sometimes sesamoids can be bipartite, which means they each comprise two separate pieces. The sesamoids are roughly the size of jelly beans. In humans the sesamoid bones act as a fulcrum for the flexor tendons, the tendons which bend the big toe downward.

In the horse it occurs at the horse's fetlock. The sesamoid bones lie behind the bones of the fetlock, at the back of the joint, and help to keep the tendons and ligaments that run between them correctly functioning.

Usually periostitis (new bone growth) occurs along with sesamoiditis, and the suspensory ligament may also be affected. Sesamoiditis results in inflammation, pain, and eventually bone growth.

Humans will also experience inflammation and pain. Sometimes the sesamoid bone will even fracture and can be difficult to pick up on X-ray. A bone scan is a better alternative.

Causes

In the horse sesamoiditis is generally caused by excess stress on the fetlock joint. Conformation that promotes sesamoiditis include long pasterns or horses with long toes and low heels.

In the human excessive forces caused by sudden bending upwards of the big toe, high heels, or a stumble can contribute to sesamoiditis. Once the sesamoid bone is injured it can be very difficult to cure because every time you walk you put additional pressure on the sesamoid bone. Treatment in humans consists of anti-inflammatory medication, cortisone injections, strapping to immobilize the big toe and orthotics with special accommodations to keep pressure off the affected bone.