Well, MY condition is akin to permanent sesamoiditis... I ALWAYS walk on the outside of my foot... because of pain in the joint. There was never just "inflammation" of the joint in my case, (prior to the surgery) the bone was shattered due to the teletype crushing the toe of the boot and driving the steel (where it creased the steel toe) into the bone right at that joint... so I felt sharp pains where the shattered bone kept poking the nerve, along with the inflammation of the joint, etc...
Now, the joint aches all the time, some days its worse than others, because if I have to walk very far, climb a lot of steps or stand on my feet for any length of time then that joint gets really sore and sometimes there's more pain than ache.
AND, if the gyno had looked at my flip flops she could have (and WOULD have) seen where the outside of my "shoes" were worn and the inside, the is very little disturbance of the sole pattern, clearly, it shows where I have been walking on the OUTSIDE of my foot. But, oh no, we can't take a look at THOSE! After all, they're just flip flops and how do we know those are YOURS? (where's the rolled eyes thingy when you need it?)