Differential Diagnosis for Pain Across Top of Foot and Altered Sensation on Shin
Single Most Likely Diagnosis
- Contusion or Bruising of the Foot or Shin: Given the recent injury 2 days ago, a contusion or bruising of the soft tissues on the top of the foot or shin is the most plausible explanation. The delayed onset of pain could be due to the gradual development of bruising and swelling.
Other Likely Diagnoses
- Dorsal Foot Stress Fracture: A stress fracture in one of the bones on the top of the foot could cause pain and altered sensation, especially if the fracture affects a nerve. The injury could have precipitated the fracture.
- Extensor Tendonitis: Inflammation of the tendons on the top of the foot could cause pain and potentially some altered sensation if the inflammation irritates nearby nerves.
- Shin Splints (Medial Tibial Stress Syndrome): While more common in the lower aspects of the shin, shin splints could potentially cause pain and altered sensation in the area described, especially if the injury exacerbated an existing condition.
Do Not Miss Diagnoses
- Compartment Syndrome: Although less likely, compartment syndrome is a medical emergency that requires prompt intervention. It could result from increased pressure within the compartments of the foot or leg, leading to pain, numbness, and potentially severe complications if not addressed.
- Deep Vein Thrombosis (DVT): While more commonly associated with the calf, a DVT could potentially cause pain and altered sensation in the shin area. Given the potential for serious complications like pulmonary embolism, it's crucial not to miss this diagnosis.
Rare Diagnoses
- Peripheral Nerve Injury: Direct injury to the nerves in the foot or shin could cause altered sensation and pain. This would be less common without a history of significant trauma.
- Osteonecrosis: Avascular necrosis of one of the bones in the foot could potentially cause pain, but this would be rare and typically associated with specific risk factors or a more significant traumatic event.
- Infection (Cellulitis or Abscess): An infection could cause pain, redness, and altered sensation. While possible, this would typically be accompanied by other signs of infection like fever, redness, and swelling.