What is the cause of a 55-year-old female's left foot pain radiating to her 3rd, 4th, and 5th toes, worsened by weightbearing?

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Differential Diagnosis for Left Foot Pain

  • Single most likely diagnosis
    • Metatarsalgia: This condition is characterized by pain in the ball of the foot, often caused by repetitive stress or poor footwear. The patient's symptoms of dorsal surface pain radiating into the 3rd, 4th, and 5th toes, worsening with weightbearing, and improvement with icing are consistent with metatarsalgia. The recent 10-hour shift in non-supportive shoes likely exacerbated the condition.
  • Other Likely diagnoses
    • Morton's neuroma: This condition involves a thickening of the tissue around the nerves leading to the toes, causing pain and discomfort. The patient's symptoms of pain radiating into the toes, particularly the 3rd and 4th toes, are consistent with Morton's neuroma.
    • Stress fracture: A stress fracture, especially in the metatarsal bones, could cause pain in the foot, worsening with weightbearing. However, the absence of trauma or falls makes this diagnosis less likely.
    • Bursitis: Inflammation of the bursae in the foot, particularly around the metatarsal bones, could cause pain and discomfort, especially with weightbearing.
  • Do Not Miss diagnoses
    • Deep vein thrombosis (DVT): Although less likely, DVT could cause foot pain, especially if it occurs in the deep veins of the foot. The patient's recent prolonged period of standing and potential for immobility increase the risk of DVT.
    • Compartment syndrome: This is a rare but serious condition that could cause foot pain, especially if it occurs in the foot or ankle. The patient's symptoms of worsening pain with weightbearing could be consistent with compartment syndrome.
  • Rare diagnoses
    • Peripheral artery disease (PAD): PAD could cause foot pain, especially with weightbearing, due to decreased blood flow to the foot. However, the patient's age and lack of other risk factors make this diagnosis less likely.
    • Gout or pseudogout: These conditions could cause sudden, severe foot pain, especially in the toes. However, the patient's symptoms of gradual onset and lack of other systemic symptoms make these diagnoses less likely.

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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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