Hi All,
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Just wondering if anyone can help with this patient I had in clinic today.
Four year old boy, no issues with developmental milestones, walking at 9 months.
PC - painful and sensitive feet
HPC - his mother reports that about 3 weeks ago he started to complain about his feet being painful and refusing to wear shoes of any kind. She has bought him flip flops which he asks to wear all the time.
No medications, surgical history, medical history or allergies
Socially - no issues
On examination:
Pulses - palpable and regular
Neurological - 10g felt at all tested sites
Nails - no issues or cryptosis
Skin - no lesions or rashes
Bio - no obvious concerns - good range of motion and within expected limits
Footwear - clarks shoes today, well fitting and with socks
I've quizzed his mother about changes which may have occurred recently; she reports no changes to washing powder or soap products. When I mentioned diet there was a small pause and she said he was on multivitamins which ran out around 5 weeks ago.
My thoughts are that it could either be a supplement deficiency or a simple childhood "thing". I've advised mom to look at his diet and to continue with monitoring his footwear use and see if a pattern emerges. Other than that, I've reassured mom with the other findings.
Does anyone have any pearls of wisdom or experience they could share.
Thanks for reading and I await any assistance you can offer.
Kind regards,
Dave
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