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Differential Diagnosis for Pain at the Middle of the Ball of the Foot with a Palpable Nodule

  • Single Most Likely Diagnosis
    • Morton's neuroma: This condition is characterized by a benign growth of nerve tissue in the ball of the foot, often between the third and fourth toes, which can cause pain and a palpable nodule in the affected area. The symptoms described match closely with those of Morton's neuroma, making it the most likely diagnosis.
  • Other Likely Diagnoses
    • Intermetatarsal bursitis: Inflammation of the bursae between the metatarsal bones can cause pain and swelling in the ball of the foot, potentially leading to a palpable nodule. This condition can mimic the symptoms of Morton's neuroma.
    • 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. While it might not always present with a palpable nodule, it's a common condition affecting the same area.
    • Sesamoiditis: Inflammation of the tendons surrounding the sesamoid bones, which are located beneath the first metatarsal bone, can cause pain in the ball of the foot. A palpable nodule could be present if there's significant swelling or if a sesamoid bone is fractured.
  • Do Not Miss Diagnoses
    • Osteoid osteoma: A small, benign bone tumor that can cause severe pain, often worse at night, and can be associated with a palpable nodule if it occurs in the bones of the foot. Although rare, missing this diagnosis could lead to prolonged pain and disability.
    • Ewing's sarcoma or other bone cancers: While extremely rare, these conditions can present with pain and swelling in the foot, including the formation of a palpable nodule. Early diagnosis is crucial for effective treatment.
  • Rare Diagnoses
    • Ganglion cyst: A non-cancerous lump that can develop on the foot, including the ball area, due to a herniation of a joint or tendon capsule. It might cause pain and could be mistaken for a nodule.
    • Plantar fibroma: A benign growth on the plantar fascia, which can cause pain and a palpable lump in the arch or ball of the foot. It's less common than other conditions listed but should be considered in the differential diagnosis.

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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