Medical Condition: Greek Foot (Morton's Toe)
The medical condition where the great toe (hallux) is significantly longer than the rest of the toes is commonly called "Greek foot" or "Morton's toe," though this term is technically a misnomer—the actual anatomical variant is a relatively short first metatarsal bone compared to the second metatarsal, making the second toe appear longer, not the great toe being longer. 1, 2
Clarification of Terminology
The question appears to describe a situation opposite to what is classically termed "Morton's foot":
- Morton's foot syndrome (Dudley Joy Morton's description) refers to a short first metatarsal bone with posterior displacement of sesamoids and hypertrophy of the second metatarsal, causing the second toe to appear longer than the great toe 1, 2
- This is a hereditary condition where excessive weight is borne by the second metatarsal head, resulting in callus formation under the second metatarsal and metatarsalgia 1
If the Great Toe is Truly Longer: Alternative Diagnoses
If the great toe is genuinely and significantly longer (superior/longer) than all other toes, consider these rare conditions:
Macrodystrophia Lipomatosa
- A rare congenital disorder causing localized gigantism with progressive overgrowth of all mesenchymal elements 3
- Characterized by disproportionate increase in fibroadipose tissues involving subcutaneous tissue, periosteum, nerves, and bone marrow 3
- X-rays show increased soft tissue with adipose tissue and increased size of involved digits with widening of ends 3
Fibrodysplasia Ossificans Progressiva (FOP)
- Children with FOP appear normal at birth except for congenital malformations of the great toes 4
- This is a severely disabling heritable disorder with worldwide prevalence of 1/1,300,000 to 1/2,000 4
- Caused by activating mutation in ACVR1/ALK2 gene 4
- A new diagnosis of FOP should be considered when evaluating suspected "masses" in toes 4
- Confirmatory genetic testing is available, though delayed diagnosis still occurs despite hallmark changes in great toes 4
Clinical Pitfalls
The most common error is confusing "Morton's toe" (where the second toe appears longer due to short first metatarsal) with a truly elongated great toe, which suggests a different pathological process entirely. 1, 2 If the great toe is genuinely enlarged or malformed from birth, FOP must be excluded given its severe progressive nature and specific management requirements 4.