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Plantar foot swelling

Discussion in 'General Issues and Discussion Forum' started by jeannestape@cox.net, Mar 4, 2012.

  1. jeannestape@cox.net

    jeannestape@cox.net Welcome New Poster


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    i have recently seen a patient with a foot problem that is stumping the local podiatrists. I was on yahoo typing in the findings hoping to stumble on something and saw this wonderful website. Hopefully you can give me some suggestings. A 55 year old female presented with the findings of a firm lump in the plantar surface of her foot. No previous history of trauma. Patient claimed that she woke up and felt like there was a lump in her shoe. The lump is located laterally in the arch of the foot at the proximal portion of the 5th and to some degree the 4th metatarsal. Although firm there is some softness through the middle of it. The podiatrist who saw her thought this was a seroma, but the MRI showed significant " muscular edema and intramuscular enhancement of the plantar lateral interossous muscles with no fracture present". The mass had been present 6 weeks before the MRI and although sore at the end of the day due to pressure from walking, the pain is not severe. After 3 weeks of using a pressure pad on the area and wearing a cast boot to the knee, the swelling is unchanged. The next suggested step is a steroid injection. I am not sure that this is such a good idea which is why I am writing. NSAIDS have been ineffective thus far. Patient has done no significant exercise for the last 3 weeks and none prior to the start of the injury. Any thoughts?
     
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