# Hallux valgus (bunion)

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Hallux Valgus - StatPearls - NCBI Bookshelf (NBK553092) - https://www.ncbi.nlm.nih.gov/books/NBK553092/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD71.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
HALLUX VALGUS (BUNION)
Sources: Hallux Valgus - StatPearls - NCBI Bookshelf (NBK553092) -
         https://www.ncbi.nlm.nih.gov/books/NBK553092/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class LD71.01 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (4)
    - Patients typically describe gradual forefoot widening along with pain, swelling, and redness
      over the inner side of the big toe joint  [redness]
    - Sharp or deep pain at the big-toe joint is worsened by walking and by tight-fitting shoes
    - Some patients also feel pain under the second metatarsal head due to overload from first-ray
      instability
    - Tingling, numbness, or burning along the top-inner side of the big toe suggests compression of
      a nearby sensory nerve  [numbness · tingling]
  SIGNS - what you find (4)
    - The classic bunion forms as the great toe drifts and rotates outward while the first
      metatarsal head shifts inward
    - Friction over the bunion prominence leads to skin and nerve irritation and bursitis underneath
    - Pressure shifted onto the lesser metatarsals, especially the second, can lead to metatarsalgia
      and eventual hammer toe deformity  [visible deformity]
    - Normal big-toe joint motion is about 15 degrees of upward bend and 65 to 75 degrees of
      downward bend; check for pain or crepitus  [crepitus]
  TESTS (4)
    - Diagnosis is mainly clinical, but weight-bearing x-rays are the gold-standard imaging to
      measure the deformity
    - Blood tests aren't routinely needed unless something points to a metabolic, inflammatory, or
      systemic cause
    - The AP x-ray view measures the hallux valgus angle and the intermetatarsal angle and shows
      sesamoid positioning
    - If deep infection or bone infection is suspected, such as with an ulcer or a prior failed
      operation, MRI or a bone scan may be used
  IF NOT THIS - what else fits (3)
    - Hallux rigidus/limitus is on the differential for hallux valgus
    - Turf toe, gout, and septic arthritis are also on the differential
    - Peripheral neuropathy and peripheral vascular disease are on the differential
  Source  StatPearls "Hallux Valgus" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Lateral deviation of the great toe with bunion formation; managed conservatively with
            footwear advice and analgesia, with surgical referral for severe or refractory
            deformity. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Lateral deviation of the great toe with bunion formation; managed conservatively with
            footwear advice and analgesia, with surgical referral for severe or refractory
            deformity.
   Caution  Skin breakdown, ulceration, or infection over the bunion, especially important in
            patients with diabetes.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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