Differential Diagnosis for Sharp Pain at the Center of the Ball of the Foot

Single Most Likely Diagnosis

• Morton's Neuroma: This condition is characterized by a sharp, burning pain in the ball of the foot, typically between the third and fourth toes. It occurs due to compression or irritation of the nerve, making it a common cause of sharp pain in this area.

Other Likely Diagnoses

• Metatarsalgia: This refers to a general term for pain in the ball of the foot, which can be sharp and is often related to overuse, poor foot mechanics, or footwear issues.
• Stress Fracture: A small crack in one of the metatarsal bones can cause sharp pain in the ball of the foot, especially with activity.
• Sesamoiditis: Inflammation of the tendons surrounding the sesamoid bones (located under the first metatarsal bone) can cause sharp pain, especially when pressure is applied.

Do Not Miss Diagnoses

• Deep Vein Thrombosis (DVT): Although less common, DVT can present with pain in the foot, including the ball of the foot, and is a medical emergency due to the risk of pulmonary embolism.
• Osteomyelitis or Septic Arthritis: Infections of the bone or joint can cause severe, sharp pain and are medical emergencies requiring prompt treatment.
• Tumor: Although rare, tumors (benign or malignant) in the foot can cause persistent or sharp pain and should not be missed.

Rare Diagnoses

• Freiberg's Disease: A rare condition that affects the metatarsal bones, causing pain and stiffness, especially in adolescents.
• Kohler's Disease: A rare bone disorder causing pain and swelling in the foot, typically affecting children.
• Gout or Pseudogout: These conditions can cause sudden, severe pain in the foot, including the ball of the foot, but are less common in this specific location compared to the big toe.