Differential Diagnosis for 2nd Toe Pain and Abdominal Symptoms
- Single most likely diagnosis:
- Traumatic toe injury (contusion or sprain): The patient's history of tripping and injuring her toe, along with symptoms of swelling, bruising, and pain, especially with movement, strongly suggests a traumatic injury to the toe.
- Other Likely diagnoses:
- Abdominal wall strain: The "weird pop" in the belly button area followed by stinging pain could indicate a strain of the abdominal wall muscles, possibly due to the fall or the effort of getting up.
- Hernia (umbilical): Although less common, the sensation of a "pop" near the belly button could potentially indicate an umbilical hernia, especially if there was increased intra-abdominal pressure during the fall or when standing up.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Internal abdominal injury: Despite the lack of other complaints, internal injuries such as a spleen or liver laceration could present with delayed symptoms. The mechanism of injury (falling) and the abdominal pain warrant consideration of these potentially life-threatening conditions.
- Fracture of the toe: While the patient's symptoms suggest a soft tissue injury, a fracture should be considered, especially if the pain is severe or if there's significant swelling and bruising.
- Rare diagnoses:
- Osteonecrosis of the toe: A less common complication of trauma, osteonecrosis could occur if the blood supply to the bone is compromised.
- Abdominal wall hematoma: Although rare, a collection of blood in the abdominal wall could occur due to trauma and might present with abdominal pain and a palpable mass.