Differential Diagnosis for Right Foot Injury
The patient presents with swelling, visible hematoma, bruising, and pain with light touch on the dorsal aspect of the foot, but has full range of motion in the ankle, good sensation in the toes, and a palpable dorsal pedis pulse. Based on these symptoms, the following differential diagnoses are considered:
- Single most likely diagnosis
- Contusion or soft tissue injury: The presence of swelling, hematoma, and bruising with pain on light touch suggests a traumatic injury to the soft tissues of the foot, which is the most common and likely diagnosis given the symptoms.
- Other Likely diagnoses
- Sprain or strain: Although the patient has full range of motion in the ankle, a sprain or strain cannot be ruled out entirely, especially if the injury involved twisting or overstretching of the foot or ankle.
- Fracture (non-displaced or stress fracture): Despite the full range of motion and lack of severe deformity, a non-displaced or stress fracture could still be present, particularly if the patient experienced significant trauma or has a history of repetitive stress.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Compartment syndrome: This is a medical emergency that requires prompt diagnosis and treatment. Although the patient has good sensation and a palpable pulse, compartment syndrome can present with pain out of proportion to the injury, and it's crucial to monitor for signs of increased pressure within the compartments of the foot.
- Deep vein thrombosis (DVT): Although less common in the foot, DVT is a potential complication, especially if the patient has been immobile or has other risk factors. The presence of swelling and pain could be indicative of a DVT.
- Rare diagnoses
- Arterial injury: Given the presence of a palpable dorsal pedis pulse, this is less likely, but an arterial injury could occur, especially with significant trauma. Monitoring for signs of decreased perfusion or ischemia is essential.
- Nerve injury: While the patient has good sensation, a nerve injury could still be present, particularly if the trauma involved significant force or compression of the nerves in the foot.