Differential Diagnosis for Mid Foot Arch Pain
The patient's history of pes cavus, mid foot arch pain, and recent onset of pain and numbness after a popping sensation suggests a range of possible diagnoses. Here is a categorized differential diagnosis:
Single most likely diagnosis
- Lisfranc Injury: Given the mechanism of injury (a pop in the mid foot region during physical activity) and the immediate onset of pain and limping, a Lisfranc injury is highly plausible. The pain and numbness extending into the hind foot on the plantar surface could be due to the involvement of nearby nerves or the spread of inflammation.
Other Likely diagnoses
- Midfoot Sprain: The patient's symptoms could also be consistent with a midfoot sprain, especially given the history of a sudden injury. The pain and numbness could be due to ligamentous injury and subsequent inflammation.
- Peroneal Tendonitis: Although less likely given the specific location of pain, peroneal tendonitis could cause pain in the mid foot region, especially if the tendons are irritated or inflamed due to the abnormal biomechanics associated with pes cavus.
- Plantar Fasciitis: This condition could cause pain in the plantar surface of the foot, including the mid arch and hind foot regions, especially if the plantar fascia is irritated or inflamed.
Do Not Miss diagnoses
- Compartment Syndrome: Although less common, compartment syndrome is a serious condition that requires prompt diagnosis and treatment. The patient's symptoms of pain and numbness, especially after a traumatic event, could be indicative of increased pressure within a closed compartment.
- Deep Vein Thrombosis (DVT): While less likely given the location and nature of the pain, DVT should be considered, especially if there are any risk factors for thrombosis. A DVT could cause pain and swelling in the foot and leg.
- Infection or Osteomyelitis: Infection or osteomyelitis could cause severe pain, especially if the patient has a history of foot ulcers or other predisposing factors. These conditions require prompt diagnosis and treatment to prevent serious complications.
Rare diagnoses
- Tarsal Coalition: This is a rare condition where there is an abnormal connection between two or more of the tarsal bones in the foot. It could cause mid foot pain, especially if the coalition is incomplete or has recently become symptomatic.
- Ganglion Cyst: A ganglion cyst could cause a lump or mass in the mid foot region, potentially leading to pain and numbness if it compresses nearby nerves.
- Neuroma: A neuroma, such as a Morton's neuroma, could cause pain and numbness in the foot, although it is less likely given the specific location and nature of the patient's symptoms.