Differential Diagnosis for Pain at Base of First Toe on Sole

• Single most likely diagnosis
  • Morton's neuroma: This condition is characterized by a benign growth of nerve tissue in the ball of the foot, commonly between the third and fourth toes, but can also occur between the first and second toes, causing pain at the base of the first toe.
• Other Likely diagnoses
  • Sesamoiditis: Inflammation of the sesamoid bones or the tendons surrounding them, which are located at the base of the first toe, can cause pain in this area.
  • Bursitis: Inflammation of the bursae (fluid-filled sacs) at the base of the first toe can lead to pain and swelling.
  • Gout: A form of arthritis that can cause sudden, severe pain and swelling in the joints, often starting at the base of the big toe.
  • Hallux rigidus: A condition characterized by stiffness and pain in the big toe, often due to arthritis, which can cause pain at the base of the first toe.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Osteomyelitis: A bone infection that can cause pain, swelling, and redness, and if left untreated, can lead to serious complications.
  • Deep vein thrombosis (DVT): A blood clot in the deep veins of the leg, which can cause pain, swelling, and warmth, and can be life-threatening if it breaks loose and travels to the lungs.
  • Diabetic foot ulcer: A wound on the foot that can become infected and lead to serious complications, such as amputation, in people with diabetes.
• Rare diagnoses
  • Freiberg's disease: A rare condition that affects the growth plate of the bones in the foot, causing pain and stiffness, often at the base of the first toe.
  • Kohler's disease: A rare condition that affects the navicular bone in the foot, causing pain and swelling, often at the base of the first toe.
  • Tarsal tunnel syndrome: A rare condition that affects the nerves in the foot, causing pain, numbness, and tingling, often at the base of the first toe.