Differential Diagnosis for Pain in Dorsum of 2-4 Metatarsals
Single Most Likely Diagnosis
- Morton's Neuroma: This condition is characterized by pain in the ball of the foot, typically between the 3rd and 4th metatarsals, but can also affect the 2nd and 3rd metatarsals. The pain is often exacerbated by wearing tight or high-heeled shoes, which compress the nerves between the metatarsals.
Other Likely Diagnoses
- Metatarsalgia: A broad term that refers to pain in the metatarsal region, often caused by repetitive stress, poor foot mechanics, or ill-fitting shoes. The pain can be diffuse or localized to specific areas, including the dorsum of the 2-4 metatarsals.
- Stress Fractures: Small cracks in the metatarsal bones, often caused by overuse or repetitive stress. These fractures can cause pain in the affected area, which may be exacerbated by weight-bearing activities or certain types of shoes.
- Capsulitis: Inflammation of the ligaments surrounding the metatarsophalangeal joints, which can cause pain and stiffness in the affected area.
Do Not Miss Diagnoses
- Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the feet, often exacerbated by heat, pressure, or certain medications. While rare, this condition can be debilitating and requires prompt diagnosis and treatment.
- Complex Regional Pain Syndrome (CRPS): A chronic pain condition characterized by intense burning or aching pain, often accompanied by swelling, redness, and hypersensitivity. CRPS can be triggered by trauma, injury, or other medical conditions.
Rare Diagnoses
- Freiberg's Disease: A rare condition characterized by avascular necrosis of the metatarsal head, often causing pain and stiffness in the affected area.
- Kohler's Disease: A rare condition characterized by avascular necrosis of the navicular bone, which can cause pain and stiffness in the midfoot region, including the dorsum of the 2-4 metatarsals.