Differential Diagnosis for 59-year-old Male with Toe Pain and Redness
- Single most likely diagnosis:
- Interdigital neuroma (Morton's neuroma): This condition is characterized by a painful, swollen mass in the ball of the foot, often between the toes, which matches the patient's symptoms of a painful ball under the 2nd and 3rd toes. The improvement in symptoms could be due to reduced pressure on the affected area.
- Other Likely diagnoses:
- Ingrown toenail: The redness on the lateral side of the great toe could be indicative of an ingrown toenail, which is a common cause of toe pain and redness.
- Bursitis: Inflammation of the bursae (fluid-filled sacs) under the toes could cause pain and redness, especially if the patient has been putting pressure on the area.
- Gout: Although less common in the toes other than the big toe, gout could still be a consideration, especially if the patient has a history of the condition.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Osteomyelitis: A bone infection that could cause pain, redness, and swelling in the foot, which might not be immediately apparent but requires prompt treatment to avoid serious complications.
- Cellulitis with abscess: A bacterial skin infection that could lead to serious consequences, such as sepsis, if not treated promptly.
- Deep vein thrombosis (DVT): Although less common in the foot, DVT could cause pain and swelling, and it's essential to consider this diagnosis due to its potential for severe complications, such as pulmonary embolism.
- Rare diagnoses:
- Erythromelalgia: A rare disorder characterized by burning pain, redness, and heat in the hands and feet, which could be a consideration if other diagnoses are ruled out.
- Complex regional pain syndrome (CRPS): A rare condition characterized by chronic pain, inflammation, and sensitivity in one of the limbs, which might be a possibility if the patient's symptoms persist or worsen over time.