Differential Diagnosis for Metatarsal Fracture with Swelling and Bruising
- Single most likely diagnosis:
- Compartment syndrome: This condition is a serious complication that can occur after a fracture, especially if the cast is too tight, leading to increased pressure within the muscle compartments of the foot. The symptoms of swelling, bruising, and potentially pain out of proportion to what is expected are classic signs.
- Other Likely diagnoses:
- Deep vein thrombosis (DVT): Immobility after a fracture and being in a cast can increase the risk of developing a DVT, which could cause swelling and discoloration of the foot.
- Infection: An infection of the skin or soft tissues around the fracture site could cause swelling, redness, and bruising, especially if the cast is not properly fitted or if there's a break in the skin.
- Fat embolism: Although less common, a fat embolism could occur after a long bone fracture, including metatarsal fractures, leading to systemic symptoms but potentially causing localized swelling and bruising due to the body's inflammatory response.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pulmonary embolism: If a DVT dislodges and travels to the lungs, it could cause a pulmonary embolism, which is life-threatening and requires immediate medical attention.
- Sepsis: An untreated infection could lead to sepsis, a condition where the body's response to an infection becomes uncontrolled and causes widespread inflammation, potentially leading to organ failure.
- Rare diagnoses:
- Complex regional pain syndrome (CRPS): A rare condition characterized by intense burning or aching pain in the affected limb, which can occur after a fracture. It might also cause swelling and changes in skin temperature and color.
- Erythromelalgia: A disorder that causes burning pain, heat, and redness in the hands and feet, which could be considered in the differential for unusual presentations of pain and swelling, although it's less directly related to fractures.