The Coughlin and Shurnas classification system is used to categorize different stages of hallux rigidus, a degenerative condition of the big toe joint (first metatarsophalangeal joint) that leads to stiffness and limited motion. This classification system helps surgeons and medical professionals assess the severity of hallux rigidus and determine appropriate treatment strategies.
The Coughlin and Shurnas classification for hallux rigidus consists of four stages:
Stage 0: No arthritic changes are present. The joint has normal or near-normal function, and there is no pain or stiffness.
Stage 1: Mild or early-stage hallux rigidus. Some joint space narrowing and osteophyte formation (bone spurs) are present. There might be mild pain and stiffness with movement.
Stage 2: Moderate hallux rigidus. The joint space is further reduced, and larger osteophytes are present. Joint motion is more restricted, and pain is more pronounced, especially during push-off while walking.
Stage 3: Severe hallux rigidus. The joint space is significantly narrowed or obliterated, and osteophytes are prominent. Joint motion is severely limited, and the patient experiences significant pain and dysfunction, even during walking.