A retrospective review of 110 foot radio-graphs of patients having hallux valgus identified the head of the first metatarsal to be shaped “round” in 100% of those having a long first metatarsal in comparison with their second metatarsal.47 When discussing this no-exception finding, the authors postulated that a long first metatarsal impedes MTP joint dorsiflexion and redirects the hallux into valgus. The finding,47 however, may be questioned because the contribution of joint erosion was not considered in the visual analysis used in classifying shape of the metatarsal head.