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Hi Guys,

I am a new grad and was wondering if anyone could help me out? I have a male friend who does ballroom dancing with me. He complains of a painful soft tissue lump/swelling at the base of of the fourth metatarsal (dorsal). Duration is 5 years. The 'lump'/pain will occur at dancing and the swelling decreases after dancing/after the shoe is removed.

I couldn't really do a full examination. Pain on dorsiflexion of the ankle. No pain with plantarflexion, eversion or inversion of the ankle. No pain on palpation.

Would it be a tendinitis/strain of EDL? Any other ideas?

Thanks, dancingpod

 

I would be thinking a bursa. Look at the shoes to see if there is anything irritataing, sometimes relacing the shoe to open up the instep can help, otherwise an ultrasound would confoirm diagnosis

 

G'day..

Sounds like it's got more to do with his shoes than anything else as Mark_M said. Could be a variety of things, but remember there's a extensor retanaculm over the area, so there's a possibility of EDL tendonitis, or irritation as it passes under the retanaculm. Also could be impingement of a dorsal cutaneout vein/lumph duct cauing a swelling. Herniation of the joint capsule over the base of the 4th-cuboid joint (highly unlikely), or a joint efflusion. Need to know more about the lump actually. Is it solid/soft/fluid filled, is it movable, what sort of pain is it? Also, pull out your anatomy books and looks what's in the area too.
Good luck!