These results suggest local inflammatory and structural factors, together with systemic factors (gender, BMI), are predominantly responsible for painful MTP joints in PsA, with no clear role for plantar pressure characteristics. MTP joint pain in PsA was independently predicted by high BMI, female gender and the presence of joint subluxation, synovitis and erosion. The presence of pain, deformity, synovitis, erosions (P < 0.001) and submetatarsal bursae and peak plantar pressure at MTP 3 (P < 0.05) were significantly higher in the PsA group. Binary logistic regression was used to identify demographic, clinical examination-derived, US-derived and plantar pressure predictors of pain at the MTP joints in the PsA group. Levels of pain, US-determined pathology and peak pressures were compared between groups. Mean barefoot peak plantar pressures were determined at each MTP joint. Thirty-four consecutive patients with PsA (mean age 45.3 years, 65% female, mean disease duration 9.9 years) and 22 control participants (mean age 37.9 years, 64% female) underwent clinical and US examination to determine the presence of pain, swelling, synovitis, erosions, effusions and submetatarsal bursae at the MTP joints. I tend to prefer "second metartarsophalangeal joint stress syndrome" but would like to have the original reference for when this term was originally coined in the medical literature.The aim of this study was to identify independent predictors of pain at the MTP joints in patients with PsA. Are there any other names for this very common clinical entity that I see approximately 10 times per week in my practice? Seidelmann: Predislocation syndrome: Progressive subluxation/dislocation of the lesser metatarsophalangeal joint. Yu et al have called the disease "predislocation syndrome" (Yu, G.V., Judge, M.S., Hudson, J.R. I was taught that this same clinical entity was called "second metartarsophalangeal joint capsulitis" 20 years ago. Note also the erosive changes at the interphalangeal joint of the great toe. (a) Axial T1-weighted MR image shows marginal erosions at the first metatarsal head (short arrows), low-signal-intensity synovial thickening (long arrows), and joint space narrowing. Does anyone know of any previous articles, or references that discuss this disease that Josh Gerbert, DPM discusses in his article that Admin lists above? Rheumatoid arthritis in a 71-year-old woman with pain at the first MTP joint. I am curious where this name of "second metartarsophalangeal joint stress syndrome" came from. a hypermobile first ray with abnormal pronation.hallux abductus with bunion deformity, which may be symptomatic and/or.possible hyperkeratotic lesion of the sub-second metatarsal head.possible adduction (splaying) of the second digit when the foot is loaded.possible dorsal dislocation of the second digit at the MTPJ.painful second hammertoe (flexible or rigid depending on the amount of time since the onset of symptoms).pain with the second MTPJ area that is well localized.pain in the sub-second metatarsal head with standing and/or ambulation.a positive modified Lachman’s test (manual subluxation of the MTPJ that creates pain).When a patient has second MTPJ stress syndrome, he or she may have the following typical signs and symptoms: Only by understanding the cause of the problem can one develop an effective treatment plan. While it is important to differentiate this entity from a neuroma, intermetatarsal bursitis or a stress fracture of a metatarsal, it is even more important for the practitioner to determine an accurate etiology or etiologies for the second MTPJ stress syndrome. Second MTPJ stress syndrome has become a catch-all term for patients who complain of chronic pain involving the second MTPJ.