Differential Diagnosis for Swollen Feet after Metatarsal Hairline Fracture
Single Most Likely Diagnosis
- Dependent Edema: This is the most likely diagnosis given the recent immobilization in a temporary cast. Immobility can lead to fluid accumulation in the dependent parts of the body, such as the feet, due to gravity, especially if the patient has been elevating the affected foot less than recommended or has been relatively inactive.
Other Likely Diagnoses
- Deep Vein Thrombosis (DVT): Although the absence of warmth might make this less likely, DVT can occur without significant warmth, especially in the early stages. Immobility from a cast increases the risk of DVT.
- Compartment Syndrome: This condition, characterized by increased pressure within a muscle compartment, can cause swelling. However, it typically presents with pain out of proportion to what is expected, pallor, paresthesia, and pulselessness, which are not mentioned here.
- Reaction to Cast Material: Some individuals may have an allergic reaction to the materials used in the cast, which could cause swelling. However, this would typically be accompanied by other signs of allergy such as rash or itching.
Do Not Miss Diagnoses
- Infection: Although the foot is not warm, infection can present in various ways, especially in diabetic patients or those with compromised immune systems. It's crucial to monitor for signs of infection, such as increased redness, warmth, or purulent discharge.
- Pulmonary Embolism (Indirectly Related): While not directly causing foot swelling, a pulmonary embolism can be a consequence of DVT and is a potentially life-threatening condition that requires immediate attention.
Rare Diagnoses
- Lymphatic Obstruction: This could potentially cause swelling but would be less common and might be associated with other symptoms or a history of conditions affecting the lymphatic system.
- Complex Regional Pain Syndrome (CRPS): This condition can cause swelling, among other symptoms like pain and changes in skin temperature and color. It's a rare but possible complication following a fracture and immobilization.