This typically involves the second toe. This is where the second toe deviates toward the great toe and can even ride over the top of the great toe. When this happens, the structure back at the knuckle behind the toe itself (second MTP joint) becomes out of alignment and can be subluxed. In severe cases the joint can also dislocate. This causes a tremendous amount of stress on the 2nd MTP joint capsule. It's not uncommon for the capsule to become attenuated or stretched and thinned out. It can have partial tearing. This can lead to pain in the joint and inflammation with local swelling.

 

When this happens, it is important to address the underlying cause of this. It's very common for this to be aggravated by other associated condition such as a bunion. It is important to address all of the associated problems so for example in this case when should address both the crossover toe and the associated bunion. It is important to get the joint back into alignment and no longer subluxed. In most pronounced cases surgery is the only way to reestablish the correct alignment to the joint.