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Head of distal phalanx of great toe

The head of the distal phalanx of the great toe (hallux) refers to the expanded distal end of the distal phalanx. It forms the bony framework of the tip of the great toe and supports the nail bed and surrounding soft tissues. It plays a critical role in weight bearing, toe-off during gait, and balance.

It is a key landmark in foot anatomy, trauma assessment, sports medicine, and imaging of the forefoot.

Synonyms

  • Distal tuft of the hallux

  • Terminal phalanx head of the great toe

Location

  • Situated at the distal end of the distal phalanx of the great toe

  • Forms the bony tip of the hallux

  • Distal to the interphalangeal joint

  • Anterior to the nail bed

  • Inferior to the nail plate

  • Superficial and subcutaneous at the toe tip

Anatomical components

  • Expanded distal osseous end of the distal phalanx

  • Cortical shell with internal cancellous bone

  • Tuft-like morphology supporting the nail bed

  • Attachment site for:

    • Fibrous septa of the pulp

    • Terminal extensor and flexor apparatus

Relations

Dorsally:

  • Nail plate and nail bed

Plantarly:

  • Toe pulp and fibrofatty tissue

Proximally:

  • Shaft of the distal phalanx

Distally:

  • Subcutaneous soft tissue of the toe tip

Medially and laterally:

  • Soft tissues of the nail folds

X-ray appearance

Plain radiographs (AP, oblique, and lateral foot views):

  • Head/tuft: Seen as a broadened, flattened distal end of the distal phalanx

  • Cortical outline: Well-defined and dense

  • Trabecular pattern: Fine cancellous texture

  • Relationship: Clearly distal to the interphalangeal joint

CT appearance

Non-contrast CT:

  • Head of distal phalanx: Well-defined bony expansion at the distal hallux

  • Cortical margins: Sharp and smooth

  • Trabecular architecture: Clearly visualized

  • Spatial detail: Excellent for assessing contour and subtle cortical irregularities

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Marrow of distal phalanx: High signal intensity

  • Head contour: Clearly delineated against surrounding soft tissues

T2-weighted images:

  • Cortex: Low signal

  • Surrounding soft tissues: Intermediate-to-high signal

  • Nail bed and pulp: Well visualized

STIR:

  • Fat suppression: Uniform suppression of marrow fat

  • Osseous margins: Well outlined

  • Soft tissues: Bright signal

Proton density fat-saturated (PD FS):

  • Bone marrow: Suppressed fat signal

  • Soft tissues: High signal contrast

CT VRT 3D image

Head of distal phalanx of great toe 3d

MRI image

Head of distal phalanx of great toe mri anatomy labelled image-img-00000-00000

CT image

Head of distal phalanx of great toe ct