Differential Diagnosis for Pain in Base of 1st Metatarsal of Right Foot
Single Most Likely Diagnosis
- Morton's Neuroma: This condition is characterized by pain in the ball of the foot, typically between the 3rd and 4th toes, but can also occur between other toes. It's caused by compression of the nerve and is often exacerbated by walking and relieved by rest.
Other Likely Diagnoses
- Metatarsalgia: A general term for pain in the ball of the foot, which can be caused by various factors including poor foot mechanics, overuse, or ill-fitting shoes. The pain is usually worse with weight-bearing activities and improves with rest.
- Stress Fracture of the Metatarsal: A small crack in one of the metatarsal bones, often caused by overuse or repetitive stress. Pain typically worsens with activity and improves with rest.
- Sesamoiditis: Inflammation of the sesamoid bones or the tendons surrounding them, located at the base of the 1st metatarsal. Pain is usually worse with weight-bearing activities, especially those involving toe-off.
Do Not Miss Diagnoses
- Osteonecrosis of the Metatarsal Head: A condition where the blood supply to the bone is disrupted, leading to bone death. It can cause severe pain and is more common in individuals with certain risk factors such as steroid use or excessive alcohol consumption.
- Infection (Osteomyelitis or Septic Arthritis): Although less common, infections in the foot can cause significant pain and have serious consequences if not promptly treated.
- Tumor (Benign or Malignant): Although rare, tumors in the foot can cause pain and should be considered in the differential diagnosis to ensure timely diagnosis and treatment.
Rare Diagnoses
- Freiberg's Disease: A rare condition characterized by avascular necrosis of the metatarsal head, typically affecting the 2nd metatarsal. It's more common in adolescents and young adults.
- Kohler's Disease: A rare condition causing pain and swelling in the foot, due to avascular necrosis of the navicular bone. It's more common in children and adolescents.
- Gout or Pseudogout: Although more commonly associated with the big toe, these conditions can cause pain in other parts of the foot, including the base of the metatarsals, especially if there are deposits of urate or calcium pyrophosphate crystals.