Differential Diagnosis for Forefoot Pain with Supination
Single Most Likely Diagnosis
- Morton's Neuroma: This condition is characterized by a thickening of the tissue around the nerves leading to the toes, often causing pain in the forefoot, particularly with supination. The pain is typically sharp and localized to the area between the toes.
Other Likely Diagnoses
- Plantar Fasciitis: Although more commonly associated with heel pain, plantar fasciitis can also cause forefoot pain, especially if the fascia is inflamed or irritated in this area. Supination can exacerbate the condition.
- Metatarsalgia: This term refers to pain in the ball of the foot, which can be exacerbated by supination. It's often related to abnormal foot mechanics or poor footwear.
- Stress Fractures: Small cracks in the bones of the foot, particularly the metatarsals, can cause pain that worsens with activity, including supination.
Do Not Miss Diagnoses
- Osteonecrosis (Avascular Necrosis): Although rare, osteonecrosis of the bones in the foot can cause severe pain and is a condition that should not be missed due to its potential for significant morbidity if not treated promptly.
- Infection (Osteomyelitis or Septic Arthritis): Infections in the foot can cause severe pain and are medical emergencies. Supination could potentially irritate an infected area, increasing pain.
- Tumor: Both benign and malignant tumors can occur in the foot and cause pain. While rare, they are critical to diagnose early for appropriate treatment.
Rare Diagnoses
- Freiberg's Disease: A rare condition characterized by avascular necrosis of the metatarsal head, leading to pain in the forefoot.
- Kohler's Disease: A rare bone disorder causing pain and swelling in the foot, typically affecting children.
- Charcot Foot: A condition that affects the nerves and joints in the foot, often due to diabetes, leading to severe pain and deformity. It's rare but critical to diagnose due to its potential for significant morbidity.