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Tuberosity of distal phalanx of great toe

The tuberosity of the distal phalanx of the great toe is a broad, roughened bony prominence located on the plantar aspect of the distal phalanx of the hallux. It forms the terminal weight-bearing surface of the great toe and provides attachment for key soft-tissue structures involved in toe stability and push-off during gait.

It is an important anatomical landmark in foot anatomy, biomechanics, trauma assessment, and imaging of the forefoot.

Synonyms

  • Apical tuberosity of the hallux distal phalanx

  • Plantar tuberosity of the distal phalanx of the great toe

Location

  • Situated at the distal end of the great toe

  • Located on the plantar (inferior) surface of the distal phalanx

  • Posterior to the nail bed and nail plate

  • Anterior to the interphalangeal joint of the hallux

  • In direct contact with the plantar soft tissues of the toe pad

Anatomical components

  • Osseous tuberosity of the distal phalanx

  • Cortical shell with underlying cancellous bone

  • Enthesis zone for soft-tissue attachments:

    • Flexor hallucis longus tendon insertion

    • Plantar aponeurosis terminal fibers

  • Weight-bearing surface:

    • Forms the bony support of the hallux pulp

Relations

Anteriorly:

  • Nail bed and nail plate

Posteriorly:

  • Interphalangeal joint of the great toe

Superiorly (dorsally):

  • Dorsal cortex of the distal phalanx

Inferiorly (plantarly):

  • Plantar fat pad of the great toe

  • Skin of the toe pulp

Medially:

  • Medial soft tissues of the hallux

Laterally:

  • Lateral soft tissues of the hallux

X-ray appearance

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

  • Tuberosity: Seen as a rounded or flattened bony prominence at the distal plantar aspect of the distal phalanx

  • Cortical outline: Smooth and well-defined

  • Trabecular pattern: Normal cancellous bone texture

  • Best seen on: Lateral and oblique views

CT appearance

Non-contrast CT:

  • Tuberosity: Well-defined bony protuberance on the plantar distal phalanx

  • Cortical margins: Smooth and sharply outlined

  • Trabecular pattern: Normal cancellous architecture

  • Spatial assessment: Excellent for evaluating contour, orientation, and subtle cortical irregularities

  • Relationship to interphalangeal joint: Clearly demonstrated

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Marrow of distal phalanx: High signal intensity

  • Tuberosity contour: Clearly delineated against plantar soft tissues

T2-weighted images:

  • Cortex: Low signal

  • Plantar fat pad: High signal

  • Joint fluid (if present): High signal outlining the distal phalanx

STIR:

  • Fat suppression: Uniform suppression of marrow and plantar fat

  • Tuberosity margins: Well visualized

  • Soft-tissue planes: Clearly delineated

Proton density fat-saturated (PD FS):

  • Bone marrow: Suppressed fat signal

  • Plantar soft tissues: High signal

  • Flexor hallucis longus tendon insertion: Seen as a low-signal band attaching near the tuberosity

CT VRT 3D image

Tuberosity of distal phalanx of great toe 3d

MRI image

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

CT image

Tuberosity of distal phalanx of great toe ct