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Painful 5th toe

Discussion in 'General Issues and Discussion Forum' started by 007Pod, Apr 2, 2009.

  1. 007Pod

    007Pod Welcome New Poster


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    Hi all,

    Any ideas regarding this case are much appreciated.

    77yr old female
    Type 2 DM
    Hx Breast Ca at 50yrs old
    HT
    Hysterectomy
    High Cholesterol
    IHD
    Moderate aortic stenosis and regurgitation

    Presents with long standing painful 5th toe, right foot at dorsal and medial aspects.
    Pain at night mostly, sometimes with tight shoes.
    Relieved slightly with interdigital padding after removing small corn medial 5th.
    Toe slightly oedematous, erythema hard to determine due to dark skin pigmentation.
    Bone scan results: No OM, evidence of synovitis or cellulitis
    X-ray results: Soft tissue calcification and irregularity at medial aspect of 5th.
    Bones osteopenic.

    Any ideas / solutions to the night pain giving this lady much grief?
    Regards,
    007Pod
     
  2. Frederick George

    Frederick George Active Member

    Sounds like she has a bone spur on her 5th toe. Is it ankylosed at the PIPJ and varus rotated? Does it hurt when you press on the corn?

    It hurts in tight shoes, and at night. Usually things hurt more at night because they are more noticeable when you are trying to get to sleep.

    So, fix the toe.

    Cheers

    Frederick
     
  3. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Chilblain?
     
  4. Frederick George

    Frederick George Active Member

    anythings possible. but a corn, with soft tissue calcification? we don't know what the lesion overlies, a lesion marker can help here. pain, or bony bump with palpation?

    007 where are you? is it cold there?

    Cheers
     
  5. Jose Antonio Teatino

    Jose Antonio Teatino Well-Known Member

    It reckoned doctor:
    It can send the x-ray?
    If there are wounds in the skin ¿can relate to a witness opaque radio in situation?
    A cordial greeting:

    Jose Antonio Teatino
    Professor of surgery
    The Academy of Ambulatory Foot & Ankle Surgery
     
  6. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    The reason I suggested that, is thats what popped into my head from just reading the thread title. Most of the times that I have been asked for advice on a painful 5th toe in which there is nothing obvious, its simply been a chilblain.
     
  7. drsarbes

    drsarbes Well-Known Member

    Interested, if you found evidence of periosteal activity or perhaps a "spur" or soft tissue Ca++ on plain films, why did you order a CT scan?

    If she has something "growing" on the toe giving her trouble, take it out.

    Steve
     
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