Differential Diagnosis for 22-year-old Female with Foot Pain after Skateboarding Accident
- Single most likely diagnosis:
- Ligament sprain: The mechanism of injury, where the patient's left foot got caught behind her right foot and she fell, is consistent with a ligament sprain. The location of the pain (anterior and lateral foot) and the severity of the pain (8/10 with weightbearing) also support this diagnosis.
- Other Likely diagnoses:
- Contusion or bruising: The patient's fall could have resulted in a contusion or bruising to the foot, which would cause pain and discomfort.
- Metatarsal stress fracture: Although the X-ray is negative, stress fractures may not be visible on initial X-rays. The patient's symptoms and mechanism of injury could be consistent with a stress fracture.
- Midfoot or forefoot sprain: The patient's pain location and mechanism of injury could also be consistent with a midfoot or forefoot sprain.
- Do Not Miss diagnoses:
- Compartment syndrome: Although less likely, compartment syndrome is a serious condition that requires prompt diagnosis and treatment. The patient's severe pain (8/10) and mechanism of injury could be consistent with compartment syndrome.
- Neurovascular injury: The patient's fall could have resulted in a neurovascular injury, which would require prompt diagnosis and treatment.
- Rare diagnoses:
- Lisfranc injury: A Lisfranc injury is a rare but serious condition that occurs when the ligaments or bones in the midfoot are injured. The patient's mechanism of injury and pain location could be consistent with a Lisfranc injury.
- Tarsal coalition: A tarsal coalition is a rare condition where two or more of the tarsal bones in the foot are abnormally connected. The patient's symptoms and mechanism of injury could be consistent with a tarsal coalition, although this is less likely.