Differential Diagnosis for Swollen Feet and Sensitive Soles
Single Most Likely Diagnosis
- Diabetic Neuropathy: Given the patient's history of diabetes (Type 1 or 2), diabetic neuropathy is a common complication that can cause sensitive soles and swollen feet due to nerve damage.
- Peripheral Edema: This condition is also common in diabetic patients and can be exacerbated by poor circulation, leading to swollen feet.
Other Likely Diagnoses
- Osteoarthritis: The patient's history of arthritis, particularly in the fingers and knuckles, increases the likelihood of osteoarthritis in other joints, including those in the feet, which could contribute to sensitive soles.
- Poor Circulation: The patient's history of open heart surgery, bypass, and angiograms suggests potential circulatory problems, which could lead to swollen feet and sensitive soles.
- Hypertension: Although not explicitly mentioned, the patient's history of cardiovascular disease increases the likelihood of hypertension, which can cause peripheral edema.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although less likely, DVT is a potentially life-threatening condition that can cause swollen feet and sensitive soles, particularly in patients with a history of surgery and cardiovascular disease.
- Cellulitis: A bacterial infection of the skin and underlying tissues, cellulitis can cause swollen, red, and sensitive skin on the feet, and is a serious condition that requires prompt treatment.
- Chronic Kidney Disease: Although the patient denies chronic kidney disease, it is essential to consider this diagnosis, as it can cause peripheral edema and is a common comorbidity with diabetes.
Rare Diagnoses
- Amyloidosis: A rare condition characterized by the deposition of abnormal proteins in various tissues, including the nerves and skin, which can cause peripheral neuropathy and sensitive soles.
- Sarcoidosis: A rare autoimmune disease that can cause inflammation and damage to various tissues, including the skin, nerves, and joints, leading to swollen feet and sensitive soles.
- Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which can cause sensitive soles.