*4.6.3. Phalanx anomalies: digital deformities*

The small bones and soft tissues of the feet can be affected by systemic disorders, and frequently, the findings are quite unique and virtually help diagnose some genetic or metabolic disorders [85]. Sometimes the changes in the structural bones of the feet, metacarpals and metatarsals, or the phalangeal units are so astonishing that they ensure the diagnosis of peculiar and rare syndromes.

There are many disorders – some genetic, some neoplastic, some inflammatory – which sometimes produce extraordinary changes in the patient's feet. In some cases, phalanx abnormalities occur as a result of the sucking of the finger by the fetus, causing elongation and hypertrophy (**Figures 12** and **13**).

**Figure 12.** Phalanx anomalies.

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**Figure 13.** Phalanx anomalies.

A small listing includes synovial chondromatosis, fibrous dysplasia, tumoral calcinosis, Maffucci syndrome, Ollier's disease, hereditary multiple osteocartilaginous exostosis, type 1 neurofibromatosis, pigmented villonodular synovitis, hyperparathyroidism, or gout.
