Differential Diagnosis for Intermittent Burning Sensation at Tip of Big Toe and Fracture of Proximal Phalanx

• Single Most Likely Diagnosis
  • Traumatic injury with nerve irritation or damage: This is the most likely diagnosis given the history of a fracture and the symptom of intermittent burning sensation at the tip of the big toe. The fracture could have caused direct damage to the nerves or led to swelling and irritation of the nerves in the area.
• Other Likely Diagnoses
  • Complex regional pain syndrome (CRPS): This condition can occur after a traumatic injury, such as a fracture, and is characterized by chronic pain, inflammation, and hypersensitivity. The burning sensation could be a symptom of CRPS.
  • Neuroma: A neuroma is a growth or tumor of nerve tissue that can occur after a nerve injury, such as from a fracture. It could cause the intermittent burning sensation described.
  • Arthritis: Certain types of arthritis, such as osteoarthritis or rheumatoid arthritis, could cause pain and inflammation in the toe, potentially leading to a burning sensation, especially if the fracture has exacerbated an underlying condition.
• Do Not Miss Diagnoses
  • Osteomyelitis or septic arthritis: Infection of the bone or joint can occur after a fracture and needs to be promptly diagnosed and treated to prevent serious complications. While less common, these conditions are critical not to miss.
  • Compartment syndrome: This is a condition where pressure within the muscles builds to dangerous levels, which can occur after a fracture. It is a medical emergency and requires immediate attention.
• Rare Diagnoses
  • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet. It could be considered in the differential diagnosis if other more common causes are ruled out.
  • Peripheral neuropathy: While more commonly associated with systemic diseases like diabetes, peripheral neuropathy could cause burning sensations in the toes. It would be less likely without a known underlying cause but should be considered if the diagnosis remains elusive.