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Differential Diagnosis for Pain in Head of Second Metatarsal and Joint

Single Most Likely Diagnosis

  • Morton's Neuroma: This condition is characterized by a benign neuroma of the intermetatarsal plantar nerve, most commonly between the third and fourth toes, but can also occur between the second and third toes, causing pain in the head of the second metatarsal and joint due to compression or irritation of the nerve.

Other Likely Diagnoses

  • Stress Fracture: Overuse or repetitive stress on the second metatarsal bone can lead to a stress fracture, causing pain in the area.
  • Metatarsalgia: This term refers to pain in the ball of the foot, which can be caused by various factors including poor foot mechanics, overuse, or ill-fitting shoes, and often affects the second metatarsal head.
  • Synovitis or Capsulitis: Inflammation of the synovial membrane or joint capsule around the metatarsophalangeal (MTP) joint of the second toe can cause pain and stiffness in the area.
  • Gout or Pseudogout: These are forms of arthritis that can cause sudden, severe pain in the joints, including the MTP joint of the second toe.

Do Not Miss Diagnoses

  • Osteomyelitis or Septic Arthritis: Infection of the bone or joint can cause severe pain and has significant consequences if not promptly treated. Although less common, these conditions are critical to diagnose early.
  • Tumor (Benign or Malignant): Although rare, tumors can occur in the bones or soft tissues of the foot and must be considered in the differential diagnosis to ensure timely and appropriate treatment.

Rare Diagnoses

  • Freiberg's Disease: A rare condition characterized by avascular necrosis of the metatarsal head, most commonly the second metatarsal, leading to pain and stiffness.
  • Kohler's Disease: A rare bone disorder causing pain and swelling in the foot, typically affecting the navicular bone but can occasionally affect other bones including the metatarsals.
  • Charcot Foot (Neuropathic Arthropathy): A condition that affects the bones, joints, and soft tissues of the foot, leading to pain, swelling, and deformity, often in patients with diabetes or other neuropathic conditions.

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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