What is the cause of left foot dorsal pain over the mid 3rd metatarsal (third metatarsal bone) and sharp pain on the plantar surface during weight-bearing activities?

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Differential Diagnosis for Left Foot Dorsal Pain and Plantar Sharp Pain

Single Most Likely Diagnosis

  • Morton's Neuroma: This condition is characterized by a sharp, burning pain in the ball of the foot, typically between the third and fourth toes, which corresponds to the area over the mid 3rd metatarsal. The pain is often exacerbated by weight-bearing activities.

Other Likely Diagnoses

  • Stress Fracture of the Metatarsal: A stress fracture in one of the metatarsal bones, particularly the third, could cause dorsal pain over the mid 3rd metatarsal and sharp pain plantarly during weight-bearing due to the increased stress on the bone.
  • Metatarsalgia: This condition involves pain and inflammation in the ball of the foot, which could be due to various factors such as poor foot mechanics, overuse, or ill-fitting shoes. It can cause both dorsal and plantar pain in the area of the mid 3rd metatarsal.
  • Capsulitis of the Metatarsophalangeal Joint: Inflammation of the joint capsule surrounding the metatarsophalangeal joint of the third toe could lead to pain both dorsally and plantarly, especially during weight-bearing activities.

Do Not Miss Diagnoses

  • Osteomyelitis or Bone Infection: Although less common, an infection of the bone in the foot could present with pain and should be considered to avoid serious complications. Early diagnosis and treatment are crucial.
  • Tumor (Benign or Malignant): A tumor in the foot, though rare, could cause persistent pain and should not be overlooked. Both benign and malignant tumors can present with similar symptoms, making diagnosis critical.

Rare Diagnoses

  • Freiberg's Disease: A rare condition that affects the metatarsal bones, causing pain and stiffness, particularly in the second metatarsal but can occasionally affect the third. It's more common in adolescents.
  • Kohler's Disease: A rare bone disorder causing pain and swelling in the foot, typically affecting the navicular bone but can occasionally present with pain in other areas of the foot.
  • Gout or Pseudogout: Although more commonly associated with the big toe, these conditions can affect other toes and areas of the foot, causing acute, severe pain.

Professional Medical Disclaimer

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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