Stage 1 – functional hallux limitus
-Limited dorsiflexion with weightbearing but normal ROM with non-weightbearing
-No DJD changes on x-ray
-No pain on end ROM
Stage 2 – joint adaptation
-Flattening of metatarsal head with small dorsal exostosis
– Pain on end ROM
Stage 3 – joint deterioration
-Severe flattening of metatarsal head with non-uniform joint space narrowing,
osteophytes, and subchondral sclerosis/cysts
-Crepitus on ROM
Stage 4 – ankylosis
-Obliteration of joint
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