Hi all
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Just wondering if anyone has any idea about this problem. I saw this 50 year old female patient a few weeks ago, took some pictures of her foot, hope you can see them in this post.
She has attended our clinic over the past few years and this problem has occured recently but it has never been seen by a doctor as it resolves within a few days. She managed to get an appointment with me the day after it occurred so this is the first time both myself and my colleague have seen it.
c/o "bruising", dicomfort and swelling on foot, has happened a few times over the last 6 months. Minimal pain, happens spontaneously and there is never any trauma involved, can be either foot and usually disappears within 3 or 4 days
o/e apparent bruising/discolouration over right 5th plantar, lateral and dorsal MPJ and extending distally into the toe.
Some pain on compression of the area, also a positive Tinels sign (could feel tingling and some pain moving proximally into her leg with tuning fork application)
States that this was a mild case and the bruising is usually more extensive, moving proximally along the 5th met
It does not occur elsewhere and is located generally over the lateral aspects of either foot
Pedal pulses were biphasic although I did find a monophasic pulse when I moved the doppler slightly distal to dorsal pedis. She has a slow capillary refill and says her feet are usually cold. Arterial insufficiency seems to be a factor but the cause of the bruising is not apparent.
It is unusual as it occurs and then disappears so quickly without any sort of trauma to the area....No significant family or medical history. She is a police officer and now has mainly a desk job.
Any thoughts or ideas would be appreciated.
Thanks
Sarah-Jane
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