Differential Diagnosis for Swollen Feet and Sensitive Soles
Single Most Likely Diagnosis
- Diabetic Neuropathy: Given the patient's history of diabetes, swollen feet and sensitive soles could be indicative of diabetic neuropathy, a common complication of diabetes that affects nerve function, often causing pain, numbness, and sensitivity in the feet.
Other Likely Diagnoses
- Arthritic Conditions: The patient's history of arthritis, particularly affecting the fingers and knuckles, suggests that arthritic conditions could also be contributing to the symptoms in the feet, possibly through similar inflammatory pathways.
- Circulatory Problems: Although the patient's circulatory history is not fully detailed, the presence of a previous open-heart surgery and the installation of a stent suggest potential circulatory issues that could lead to swelling and sensitivity in the feet due to poor blood flow.
- Dry Skin Condition: The patient mentions having dry skin, which could contribute to sensitivity, especially if the dryness is pronounced on the soles of the feet.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although less likely, DVT is a potentially life-threatening condition that could cause swelling and sensitivity in one leg. Given the patient's history of surgery and potential for circulatory problems, it's crucial not to miss this diagnosis.
- Cellulitis or Infection: Bacterial infections like cellulitis can cause swelling, redness, and sensitivity in the skin. In diabetic patients, the risk of infections can be higher due to neuropathy and potentially compromised immune response.
- Chronic Kidney Disease (CKD) Complications: Although the patient denies CKD, if there were an undiagnosed issue, CKD could lead to fluid retention and swelling. It's essential to consider this, especially with the patient's complex medical history.
Rare Diagnoses
- Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which could potentially cause sensitivity in the soles.
- Complex Regional Pain Syndrome (CRPS): A condition that can cause severe, burning pain, and sensitivity, usually in an arm or leg, after an injury or trauma. It's less likely but should be considered if other diagnoses are ruled out.