Differential Diagnosis for Clicking in Distal Interphalangeal Joint of Second Toe

• Single most likely diagnosis:
  • Morton's neuroma: This condition, although more commonly associated with the third interspace, can cause clicking or snapping sensations due to the compression of the intermetatarsal nerve. However, given the specific location in the distal interphalangeal joint, it's less likely but still worth considering due to its prevalence in toe issues.
• Other Likely diagnoses:
  • Ganglion cyst: A common condition that can cause a clicking or snapping sensation, especially if the cyst is located near a joint and interferes with the movement, leading to the clicking sound.
  • Sesamoiditis or sesamoid fracture: Although more commonly associated with the first metatarsophalangeal joint, any condition affecting the sesamoid bones under the toes could potentially cause clicking due to altered biomechanics or bone fragments.
  • Osteoarthritis: Wear and tear of the joint can lead to loose fragments or irregular joint surfaces, causing clicking sounds during movement.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
  • Infection (septic arthritis): Although rare, an infection within the joint can lead to severe consequences if not promptly treated, including destruction of the joint and systemic infection.
  • Tumor (benign or malignant): A tumor within or near the joint could cause mechanical symptoms, including clicking, due to its presence and effect on surrounding structures.
• Rare diagnoses:
  • Synovial chondromatosis: A rare condition where cartilage grows within the synovium of the joint, potentially leading to loose bodies that can cause clicking or locking sensations.
  • Ligamentous or tendon injuries: Direct injuries to the ligaments or tendons surrounding the distal interphalangeal joint could lead to instability and clicking sensations, though these are less common in the context provided.