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Hallux Valgus N063

Last amended 
29 November 2016

In this section

Current RMA Instruments
Reasonable Hypothesis
98 of 2015
Balance of Probabilities
99 of 2015
Changes from previous Instruments

SOP Bulletin 185

ICD coding

ICD-9-CM:       735.0

ICD-10-AM:    M20.1

Brief description

This is a deformity of the big toe (hallux) where the distal end of the toe is deflected laterally (away from the midline). This results in a bulge at the first metatarsophalangeal joint which can become larger due to friction induced bone growth, bursa and skin callus. The bony or soft tissue growth is also called a bunion. 

Confirming the diagnosis

To confirm the diagnosis there needs to be evidence of clinical signs of great toe deformity. The nature of the deformity is further delineated by xray or MRI scan imaging.

The relevant medical specialist is an orthopaedic surgeon or sports physician.

Additional diagnoses covered by these SOPs
  • Big toe bunion.

Conditions not covered by these SOPs   
  • Congenital hallux valgus# - (ICD-9 755.66; ICD-10 Q66.89)

  • Osteoarthritis of the first metatarsophalangeal joint* - Osteoarthritis. However the Hallux valgus may be present in addition to the osteoarthritis.

* another SOP applies  - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

Hallux valgus may be asymptomatic.  The clinical onset will be the date of first diagnosis, the date of first symptoms due to hallux valgus being present, or the date when siginicant deformity (lateral toe deviation) was first noticed.   

Clinical worsening

When considering any issues concerning possible clinical worsening, it is important to ascertain whether the clinical worsening is out of keeping with the natural history of the underlying pathology.

The natural history of hallux valgus is to get worse with the passage of time. The treatment is to remove the causative factors if possible. Hallux valgus does not have a high level of impairment, but if necessary the toe can be surgically realigned or the joint fused.

Comments on SOP factors

Wearing footwear factor: This commonly will occur with use of high heel shoes in women where the front of the shoe is narrowed forcing the big toe laterally. It is unclear whether military shoes or boots would have had a narrowed anterior compartment, but a shoe or boot that was too small may have compressed the big toe laterally.