Differential Diagnosis for Left Big Toe Pain
Single Most Likely Diagnosis
- Morton's Neuroma: This condition is characterized by shooting pain, stabbing, and burning sensations, especially when pressure is applied to the affected area. The onset of symptoms 5 days ago and worsening with walking are consistent with Morton's Neuroma, which often affects the area between the third and fourth toes but can also occur in the big toe.
Other Likely Diagnoses
- Ingrown Toenail: This condition can cause pain, especially when pressure is applied, and can lead to stabbing and burning sensations. The location on the pad of the toe and the worsening of symptoms with walking are consistent with an ingrown toenail.
- Plantar Fat Pad Atrophy: This condition involves the loss of the fatty tissue under the toe, leading to increased pressure on the skin and underlying structures, causing pain that can be stabbing and burning, especially with weight-bearing activities like walking.
- Sesamoiditis: Inflammation of the sesamoid bones under the big toe can cause pain, especially with pressure and weight-bearing activities, which could explain the stabbing and burning sensations described.
Do Not Miss Diagnoses
- Osteomyelitis or Septic Arthritis: Although less likely, these infections can cause severe pain, redness, and swelling. Missing these diagnoses could lead to serious complications, including bone or joint destruction. The acute onset and severity of pain, especially if accompanied by signs of infection like redness, warmth, or fever, would necessitate urgent evaluation.
- Deep Vein Thrombosis (DVT): While DVT typically presents with swelling, redness, and warmth of the entire leg, in rare cases, it could cause localized pain. Given the potential for severe consequences if missed, DVT should be considered, especially if there are risk factors present.
Rare Diagnoses
- Gout or Pseudogout: These conditions can cause sudden, severe pain in the big toe, often accompanied by redness and swelling. While they are more commonly associated with the joint, they could potentially cause pain in the pad of the toe if a tophus (deposit of uric acid crystals) forms in that area.
- Neurological Conditions: Certain neurological conditions, such as peripheral neuropathy or nerve entrapment syndromes, could potentially cause the described symptoms, although they would be less common causes of localized pain in the pad of the big toe.