Nonsurgical treatment of monarticular nontraumatic synovitis of the second metatarsophalangeal joint

Thirteen patients with second metatarsophalangeal joint synovitis in 14 feet were seen during 4.5 years for monarticular nontraumatic synovitis of the metatarsophalangeal joint. They were treated with a nonsurgical regimen of intra-articular corticosteroids, along with the modification of a regular laced shoe to provide a rockerbottom effect. Nine feet of 8 patients were available for follow-up at an average of 75 months. Seven feet were asymptomatic, with no recurrence. One patient with bilateral involvement continued with symptoms unchanged. There were no recurrences. The treatment was unsuccessful for one patient who underwent surgical synovectomy. The above regimen seems to satisfactorily resolve the symptoms in 70% of the patients treated.