Differential Diagnosis for Sudden Foot Drop in a 14-Year-Old Boy
Single Most Likely Diagnosis
- Peroneal nerve injury or compression: This is a common cause of foot drop, especially in adolescents who may have experienced a traumatic injury during sports or other physical activities. The peroneal nerve can be compressed or injured, leading to weakness or paralysis of the muscles it supplies, resulting in foot drop.
Other Likely Diagnoses
- L5 radiculopathy: This refers to damage or irritation of the L5 nerve root, which can cause foot drop. It can be due to a herniated disk, spondylolisthesis, or other spinal conditions.
- Muscular dystrophy: Certain types of muscular dystrophy, such as Duchenne muscular dystrophy, can cause progressive muscle weakness, including foot drop.
- Infection or inflammation: Conditions like osteomyelitis or abscesses near the peroneal nerve can cause foot drop.
Do Not Miss Diagnoses
- Spinal cord tumor or compression: Although less common, spinal cord tumors or compression can cause foot drop. Missing this diagnosis could lead to delayed treatment and potentially severe consequences, including paralysis.
- Guillain-Barré syndrome: This is an autoimmune disorder that can cause rapid onset of muscle weakness, including foot drop. It requires prompt recognition and treatment to prevent respiratory failure.
- Vascular injury or occlusion: Injury to the blood vessels supplying the lower extremities can cause foot drop due to ischemia.
Rare Diagnoses
- Charcot-Marie-Tooth disease: A group of inherited disorders that affect the peripheral nerves, leading to progressive muscle weakness and atrophy, including foot drop.
- Poliomyelitis: Although rare in developed countries due to vaccination, polio can cause foot drop as part of its presentation.
- Neurodegenerative disorders: Certain rare neurodegenerative disorders, such as hereditary spastic paraplegia, can cause foot drop among other symptoms.