Radiologic Anatomy of the Painful Bunionette

Radiographs were studied of 91 feet in 62 patients with the diagnosis of bunionette and no prior bunionette or hallux valgus operations. Various radiologic measure-ments were compared to a matched control group with no bunionette symptoms or previous forefoot operations. The bunionette group had a significantly increased metatar-sophalangeal 5 angle, intermetatarsal 4-5 angle, and in-termetatarsal 1·2 angle compared to the control group. Bunionettes were not commonly associated with lateral bowing of the fifth metatarsal or with an increased fifth metatarsal head width. Symmetry was noted between symptomatic and opposite asymptomatic feet, with the exception of an increased intermetatarsal 4-5 angle in the symptomatic feet. Tailor's bunion or bunionette is a lateral forefoot condition consisting of a painful prominence over the distal fifth metatarsophalangeal (MTP) joint. This symp-tomatic prominence may involve soft tissue, bone, or a combination of both. Previous reports in the literature have attributed the cause of bunionette to chronic irritation of the lateral forefoot due to pressure.F":": " Lateral forefoot pres-sure from sitting cross-legged gave rise to the eponym "tailor's bunion.'? Another suggested cause is in-creased intermetatarsal 4-5 angle, either congenitally or acquired.3,6,11,13 Lateral deviation of the fifth metatar