Bone Spur Big Toe

Subungual exostoses are osteochondromas. They occur mainly under the medial nail folds of the great toes, although they can appear on the lesser toes. They present with a complaint of pain in the toe, sometimes localized to the nail fold. Sometimes the swelling itself may cause pressure on the shoe. Some have a history of trauma or previous ingrown nail surgery (which may have been for an "ingrowing toenail' that was, in fact, the exostosis). Examination shows a firm swelling under the nail. As opposed to straight ingrown nail pain, there is pain with direct pain to the nail plate. Pain is not localized to a border of the nail as it would be in an ingrown nail. Treatment consists of direct removal of the spur. The x-ray shown to the right shows a clear indication of the "bump" that sits right underneath your toenail.