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Bunions - Management
How should I assess someone with bunions?
- Establish the reason for consultation. The person may:
- Require symptomatic relief only.
- Have difficulty in fitting into footwear (resulting in skin trauma).
- Have no symptoms but dislike the look of their foot or the type of footwear that must be worn to accommodate the foot.
- Assess for severity:
- Ask about the location and duration of pain and the presence of paraesthesia (not all people with bunions are symptomatic).
- Ask how the symptoms are affecting the person's lifestyle.
- Assess the degree of deformity: mild, moderate, or severe (weight-bearing X-rays are not done in primary care).
- Assess for degenerative joint disease (which may develop in people with long-standing or severe bunions).
- Assess for coexisting osteoarthritis (more likely in people with long-standing or severe bunions).
- Rule out alternative diagnoses, such as gout or sesamoiditis.
- Enquire about a medical history of diabetes, vascular disease, or neuropathy.
- Assess footwear, and ask what types of shoes are normally worn and whether there has been any recent change in footwear.
- Enquire about treatments that have already been tried, such as bunion pads or over-the-counter analgesics.
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