Articles

Cases

Courses

SCHEDULED DOWNTIME: We will be performing a database migration that will result in the site being unavailable for approximately 1 hour starting at UTC: Monday, 20 May 2024 11:00 PM (check your local time here

Symphalangism

Changed by Craig Hacking, 12 Jan 2023

Back to revision history

Disclosures - updated 30 Aug 2022:

Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)

Updates to Article Attributes

Body was changed:

Show markup changes

Symphalangism refers to ankylosis or synostosis of the interphalangeal joints (i.e. fusion of the phalanges) in either the toes or the fingers. Less commonly, the metacarpophalangeal joints may be affected.

Epidemiology

One study reports symphalangism of the fifth toe in ~55% (range 40-75%) of the population. It less commonly affects the fourth (~5%) and third toes (~1%) in descending incidence ¹.

Associations

Symphalangism may also be associated with many conditions including ³:

Clinical presentation

Stiffness, lack of volar skin fold and reduced range of motion may be present ⁴. More often, it is an incidental finding on radiographs.

Pathology

Symphalangism is most commonly seen as an isolated anatomical variant as a fusion of the middle and distal phalanges in the 5^th toe ¹.

Historical and etymology

Symphalangism was coined by Howard Cushing in 1916 ².

-<p><strong>Symphalangism</strong> refers to ankylosis or <a href="/articles/synostosis">synostosis</a> of the <a href="/articles/interphalangeal-joint-of-the-foot">interphalangeal joints</a> (i.e. fusion of the phalanges) in either the toes or the fingers. Less commonly, the <a href="/articles/metacarpophalangeal-joints">metacarpophalangeal joints</a> may be affected.</p><h4>Epidemiology</h4><p>One study reports symphalangism of the fifth toe in ~55% (range 40-75%) of the population. It less commonly affects the fourth (~5%) and third toes (~1%) in descending incidence <sup>1</sup>.</p><h5>Associations</h5><p>Symphalangism may also be associated with many conditions including <sup>3</sup>:</p><ul>
~~-<li>~~
~~-<a href="/articles/apert-syndrome">acrocephalosyndactyly</a> (Apert syndrome)</li>~~
~~-<li>~~
~~-<a href="/articles/carpal-coalition">carpal</a>/<a href="/articles/tarsal-coalition">tarsal coalition</a>~~
~~-</li>~~
~~-<li><a href="/articles/cushing-symphalangism">Cushing symphalangism</a></li>~~
+<p><strong>Symphalangism</strong> refers to ankylosis or <a href="/articles/synostosis">synostosis</a> of the <a href="/articles/interphalangeal-joint-of-the-foot">interphalangeal joints</a> (i.e. fusion of the phalanges) in either the toes or the fingers. Less commonly, the <a href="/articles/metacarpophalangeal-joints">metacarpophalangeal joints</a> may be affected.</p><h4>Epidemiology</h4><p>One study reports symphalangism of the fifth toe in ~55% (range 40-75%) of the population. It less commonly affects the fourth (~5%) and third toes (~1%) in descending incidence <sup>1</sup>.</p><h5>Associations</h5><p>Symphalangism may also be associated with many conditions including <sup>3</sup>:</p><ul>
+<li>
+<a href="/articles/apert-syndrome">acrocephalosyndactyly</a> (Apert syndrome)</li>
+<li>
+<a href="/articles/carpal-coalition">carpal</a>/<a href="/articles/tarsal-coalition">tarsal coalition</a>
+</li>
+<li><a href="/articles/cushing-symphalangism">Cushing symphalangism</a></li>

Images Changes:

Image 4 X-ray (Oblique) ( update )

Caption was changed:

Case 4: ~~little~~5th toe symphalangism with fracture

Image 5 X-ray (Oblique) ( update )

Caption was changed:

Case 5: ~~little~~5th toe pedal biphalangism with fracture

Image 6 X-ray (Frontal) ( create )

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":8202475,"studyId":31629,"caseSlug":"third-fourth-and-fifth-toe-symphalangism","caption":"Case 1: third, fourth and fifth toe symphalangism","thumbnail":"https://prod-images-static.radiopaedia.org/images/8202475/7c1778e68e00fd5a98804c9c2fa3de_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":8199122,"studyId":31616,"caseSlug":"symphalangism-of-the-fifth-toe-with-fracture","caption":"Case 2: fifth toe symphalangism with fracture ","thumbnail":"https://prod-images-static.radiopaedia.org/images/8199122/96d6531addbba9c44a292bd47c8892_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":8621698,"studyId":32278,"caseSlug":"symphalangism","caption":"Case 3: 1st-4th PIP fusion","thumbnail":"https://prod-images-static.radiopaedia.org/images/8621698/762c7977010dd4abaaf0b8dedd01ee_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":26600631,"studyId":54734,"caseSlug":"symphalangism-of-little-toe-with-fracture","caption":"Case 4: 5th toe symphalangism with fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/26600631/d63f0aa908547acfc5858503d1b583_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":51412540,"studyId":80301,"caseSlug":"pedal-biphalangism-with-fracture","caption":"Case 5: 5th toe pedal biphalangism with fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/51412540/bab05b6a289b1636aec1d7980fea0f_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":60819344,"studyId":130933,"caseSlug":"symphalangism-of-fifth-toe-with-intra-articular-fracture","caption":"Case 6: with fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/60819344/07fa03baff63a6dc6742734707be9583ceb5bb560606dd9e438e846f0985216b_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"}],"ddx_inclusions":[],"lang":"us"}