What causes forefoot pain (metatarsalgia)?

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Differential Diagnosis for Forefoot Pain

Single Most Likely Diagnosis

  • Morton's Neuroma: This condition is a common cause of forefoot pain, characterized by a benign growth of nerve tissue between the toes, typically between the third and fourth toes. It is often associated with wearing tight or high-heeled shoes.

Other Likely Diagnoses

  • Plantar Fasciitis: Inflammation of the plantar fascia, a band of tissue that runs along the bottom of the foot, can cause pain in the forefoot, especially with weight-bearing activities.
  • Metatarsalgia: This condition refers to pain and inflammation in the metatarsal area, often due to overuse, poor foot mechanics, or ill-fitting shoes.
  • Bunions: A bunion is a bony growth that can develop at the base of the big toe, causing pain and discomfort in the forefoot.
  • Hammer Toes: Abnormal contraction of the toes can lead to pain and discomfort in the forefoot, especially if shoes are too tight.

Do Not Miss Diagnoses

  • Infection (e.g., Cellulitis or Abscess): Infections in the forefoot can be serious and require prompt medical attention. Symptoms may include redness, swelling, warmth, and increased pain.
  • Deep Vein Thrombosis (DVT): Although less common, DVT can cause forefoot pain and swelling, and is a medical emergency due to the risk of pulmonary embolism.
  • Gout: This form of arthritis can cause sudden, severe pain in the forefoot, often accompanied by redness and swelling.
  • Diabetic Foot Ulcer: In people with diabetes, foot ulcers can develop and cause forefoot pain, and are at risk of becoming infected.

Rare Diagnoses

  • Freiberg's Disease: A rare condition that affects the metatarsal bones, causing pain and stiffness in the forefoot.
  • Kohler's Disease: A rare bone disorder that affects the navicular bone, causing pain in the forefoot.
  • Charcot Foot: A rare condition that affects people with diabetes, causing destruction of the bones and joints in the foot, leading to forefoot pain and deformity.
  • Erythromelalgia: A rare disorder that causes burning pain, heat, and redness in the feet, including the forefoot.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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