Differential Diagnosis for 4-Day Right Foot/Great Toe Pain
- Single most likely diagnosis
- Compartment Syndrome: This is the most likely diagnosis given the sudden onset of pain and redness after removing the boot, throbbing pain, and worsening pain with walking and bending. The use of new boots with a composite toe and physical activity like cutting trees all day could have led to increased pressure within the compartments of the foot.
- Other Likely diagnoses
- Blister or Soft Tissue Injury: The new boots could have caused friction leading to blisters or soft tissue injury, especially with the physical activity described.
- Overuse Injury or Strain: Cutting trees all day could lead to overuse injuries or strains in the foot, especially if the patient is not accustomed to such activity.
- Gout: Although less likely without a history of gout, the sudden onset of severe pain in the great toe could suggest gout, especially if the patient has risk factors.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cellulitis or Infectious Process: Infection could present with redness and pain, and it's crucial to consider this, especially if the cut from the boot led to an open wound.
- Deep Vein Thrombosis (DVT): Although less common in the foot, DVT could present with pain and swelling, and it's a critical diagnosis not to miss due to the risk of pulmonary embolism.
- Osteomyelitis: If the patient has an open wound from the boot and develops signs of infection, osteomyelitis (bone infection) is a potential, though less likely, diagnosis that could have severe consequences if not treated promptly.
- Rare diagnoses
- Complex Regional Pain Syndrome (CRPS): This is a rare condition characterized by intense burning or aching pain in the hands or feet after an injury or trauma. It could be considered if the pain is disproportionate to the injury and other diagnoses are ruled out.
- Neuroma: A neuroma could cause pain in the foot, especially if it involves the nerves between the toes. However, this would be less likely given the acute onset and description of the pain.