Hallux varus is more commonly seen in which condition?

• A. Osteoarthritis
• B. Rheumatoid arthritis
• C. Gout
• D. Psoriatic arthritis

Answer: (A)

Hallux varus is medial deviation of the big toe at the first metatarsophalangeal joint, the opposite of the common bunion (hallux valgus). This deformity arises when the joint and surrounding soft tissues become imbalanced, allowing the toe to drift toward the midline. Degenerative osteoarthritis of the first MTP joint tends to cause asymmetric wear, osteophyte formation, and joint incongruity, which commonly pulls the toe into varus as the medial structures tighten and the lateral support is overwhelmed. Because of this pattern of degenerative change around the joint, hallux varus is most typically associated with osteoarthritis.

In rheumatoid arthritis, deformities around the big toe more often involve hallux valgus with subluxation due to synovial inflammation and ligamentous laxity; gout and psoriatic arthritis can affect the toe joints as well, but hallux varus is not its characteristic deformity.