Symphalangism
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Symphalangism refers to ankylosis 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.
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
Most commonly seen as an isolated anatomical variant as the fusion of the middle and distal phalanges in the 5th toe 1.
Associations
Symphalangism may also be associated with many conditions including 3:
- acrocephalosyndactyly (Apert syndrome)
- carpal/tarsal coalition
- Cushing symphalangism
Historical and etymology
First named by Dr Howard Cushing in 1916 2.
-<p><strong>Symphalangism</strong> refers to ankylosis of the <a href="/articles/interphalangeal-joints">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><h4>Clinical presentation</h4><p>Stiffness, lack of volar skin fold and reduced range of motion may be present <sup>4</sup>. More often, it is an incidental finding on radiographs.</p><h4>Pathology</h4><p>Most commonly seen as an isolated anatomical variant as fusion of the middle and distal phalanges in the 5th toe <sup>1</sup>.</p><h5>Associations</h5><p>Symphalangism may also be associated with many conditions including <sup>3</sup>:</p><ul>- +<p><strong>Symphalangism</strong> refers to ankylosis of the <a href="/articles/interphalangeal-joints">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><h4>Clinical presentation</h4><p>Stiffness, lack of volar skin fold and reduced range of motion may be present <sup>4</sup>. More often, it is an incidental finding on radiographs.</p><h4>Pathology</h4><p>Most commonly seen as an isolated anatomical variant as the fusion of the middle and distal phalanges in the 5th toe <sup>1</sup>.</p><h5>Associations</h5><p>Symphalangism may also be associated with many conditions including <sup>3</sup>:</p><ul>
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