What is the diagnosis for a bony excrescence on the distal end of the great toe phalanx?

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Differential Diagnosis for Bony Excrescence on Distal End of Great Toe Phalanx

  • Single Most Likely Diagnosis
    • Hallux valgus with associated bunion or osteophyte formation: This is a common condition where the big toe deviates towards the second toe, often resulting in a bony prominence on the distal end of the great toe phalanx due to osteophyte formation or bunion development.
  • Other Likely Diagnoses
    • Traumatic avulsion fracture: A history of trauma could lead to an avulsion fracture at the distal end of the great toe phalanx, presenting as a bony excrescence.
    • Osteochondroma: A benign bone tumor that can occur on the distal end of bones, including the phalanges, and may present as a bony excrescence.
    • Enchondroma: A type of benign bone tumor that originates from cartilage and can cause a bony excrescence, especially if it involves the distal phalanx.
  • Do Not Miss Diagnoses
    • Osteosarcoma or other malignant bone tumors: Although rare, these conditions can present with a bony excrescence and would have significant implications for treatment and prognosis if missed.
    • Infection (osteomyelitis): Chronic infection of the bone can lead to formation of a bony excrescence or sequestrum, which would require prompt antibiotic treatment or surgical intervention.
  • Rare Diagnoses
    • Turret exostosis: A rare condition characterized by a bony growth on the distal phalanx, often associated with a history of trauma.
    • Subungual exostosis: A benign bone tumor that occurs under the nail, which can cause a bony excrescence on the distal end of the great toe phalanx.
    • Multiple hereditary exostoses: A rare genetic condition characterized by the development of multiple osteochondromas, which could potentially involve the distal end of the great toe phalanx.

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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