Differential Diagnosis for Top of Foot Pain

• 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 with activities that involve toe extension.
  • Morton's Neuroma: Although more commonly associated with pain between the toes, Morton's neuroma can sometimes cause pain on the top of the foot due to compression of the nerve.
  • Gout: Gouty arthritis can cause sudden, severe pain in the foot, including the top, due to the deposition of urate crystals.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
  • Compartment Syndrome: A condition where increased pressure within the muscle compartments of the foot can lead to nerve and muscle damage. It is a medical emergency.
  • Deep Vein Thrombosis (DVT): Although less common in the foot, DVT can cause pain and swelling and is a serious condition that requires immediate medical attention due to the risk of pulmonary embolism.
• Rare diagnoses
  • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which can sometimes be localized to the top of the foot.
  • Freiberg's Disease: A rare condition that affects the metatarsal bones in the foot, causing pain on the top of the foot, especially in adolescents.
  • Bone Tumors: Although rare, tumors such as osteoid osteoma can cause localized pain on the top of the foot.