Differential Diagnosis for Pediatric Great Toe Pain without Injury
Single Most Likely Diagnosis
- Sesamoiditis: This condition is a common cause of great toe pain in children, especially in those who are actively involved in sports or activities that involve running or jumping. The sesamoid bones are two small bones located under the first metatarsal bone, and inflammation or irritation of these bones can cause pain.
Other Likely Diagnoses
- Gout: Although less common in children, gout can occur and cause great toe pain. It is often associated with a family history of gout and may be triggered by certain medications or medical conditions.
- Osteochondritis dissecans: This condition involves the separation of a piece of cartilage and bone from the surrounding bone, which can cause pain and swelling in the affected area.
- Ingrown toenail: An ingrown toenail can cause pain, redness, and swelling in the great toe, especially if it becomes infected.
- Overuse or repetitive strain: Children who participate in sports or activities that involve repetitive running, jumping, or kicking may experience great toe pain due to overuse or repetitive strain.
Do Not Miss Diagnoses
- Osteomyelitis: This is a bone infection that can cause severe pain, swelling, and redness in the affected area. It is a medical emergency that requires prompt treatment with antibiotics.
- Septic arthritis: This is a joint infection that can cause severe pain, swelling, and redness in the affected area. It is a medical emergency that requires prompt treatment with antibiotics.
- Tumor or cyst: Although rare, a tumor or cyst can cause great toe pain in children. It is essential to consider this possibility to ensure prompt diagnosis and treatment.
Rare Diagnoses
- Kohler's disease: This is a rare condition that affects the navicular bone in the foot and can cause pain and swelling in the great toe.
- Freiberg's disease: This is a rare condition that affects the metatarsingle bones in the foot and can cause pain and swelling in the great toe.
- Avascular necrosis: This is a rare condition that occurs when the blood supply to a bone is disrupted, causing the bone to die. It can cause great toe pain in children, especially those with a history of trauma or certain medical conditions.