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Last updated: October 26, 2025View editorial policy

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Differential Diagnosis for Foot Pain on Top

  • Single most likely diagnosis
    • Stress Fracture: This is a common cause of pain on the top of the foot, especially in athletes or individuals who have recently increased their physical activity. Stress fractures are small cracks in the bone that can occur due to repetitive stress or overuse.
  • Other Likely diagnoses
    • Extensor Tendinitis: Inflammation of the tendons that run along the top of the foot can cause pain, especially when walking or running. This condition is common in people who wear poorly fitting shoes or have abnormal foot mechanics.
    • Morton's Neuroma: A condition where the tissue around a nerve leading to the toes becomes inflamed, causing pain between the toes and on the top of the foot. It's more common in women and people who wear high-heeled or tight shoes.
    • Gout: A form of arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness, often occurring at the base of the big toe but can also affect the top of the foot.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Deep Vein Thrombosis (DVT): Although less common, DVT can cause pain in the foot, including the top, due to a blood clot in the deep veins. It's crucial to consider this diagnosis, especially in patients with risk factors such as recent surgery, immobilization, or cancer.
    • Osteomyelitis: An infection of the bone that can cause severe pain, redness, and swelling. It's a serious condition that requires prompt medical attention to prevent long-term damage.
  • Rare diagnoses
    • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which can include the top of the foot. It can be primary or secondary to other conditions like myeloproliferative disorders.
    • Complex Regional Pain Syndrome (CRPS): A chronic pain condition that most often affects one of the arms, legs, hands, or feet after an injury or trauma. It's characterized by intense burning or aching pain and can be rare but should be considered in persistent, unexplained cases of foot pain.

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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