There was no swelling, redness, skin discoloration, scar tissue, or deformity in the hindfoot, midfoot, and forefoot sections of the patient’s left foot. Synovitis of the metatarsal-cuneiform jointįindings from the physical examination included the following:.Extensor tendinopathy of the tibialis anterior tendon.Stress fracture of the base of the first metatarsal bone.Possible disorders in the differential diagnosis include the following: He received an injection of corticosteroids and anesthetic in the painful area, but there was no result. The patient currently was using over-the-counter NSAIDs, which helped marginally. He stopped all his physical activity because of limitations imposed by his left foot pain. The patient kept fit by playing tennis on a regular basis and running about 10 to 15 miles per week, primarily on a treadmill but also on roads and cross-country. The findings were largely unremarkable, with no significant history of musculoskeletal disease. He denied any previous injury to the left foot. There was no bruising, swelling, skin discoloration, skin lesion, temperature change, or obvious deformity, although the patient felt stiffness in his midfoot joints, with some limitation in the first MTP joint. After a variable period of rest, the pain would decrease in intensity but became a more diffused, dull, aching pain over the whole medial dorsal surface of the left foot. At first, it was not localized, but it worsened after about 5 minutes of walking. The patient felt a severe, sharp, shooting pain. The pain had a gradual onset and worsened with continued running. There was no obvious history of acute trauma or injury to the left foot. The pain originally occurred while the patient was running on a treadmill 2½ years earlier. He sometimes felt numbness around the medial dorsal surface of the midfoot and forefoot. He experienced some pain relief with rest, and the duration was variable. It was induced and increased with weight-bearing activities while the patient walked, ran, and jumped. The pain sometimes disturbed sleep and caused the patient to have difficulty in going to sleep, although that varied with the patient’s activity level during the day. It was rated between 0/10 and 8/10 on the Numeric Pain Scale. The patient described the pain as sharp and throbbing with variable intensity. There was some radiating pain over the first metatarsophalangeal (MTP) joint. The main area of pain appeared to be over the medial dorsal area of the forefoot, around the base of the first metatarsal bone. The goal is to illustrate the importance of the history and investigations in the management of foot pain in athletes.Ī 29-year-old white man who is a writer and an avid runner presented to the clinic with a 2½-year history of left midfoot pain on the dorsal area of the first metatarsal-cuneiform joint. In this article, we present a rare case of stress fracture of the base of the first metatarsal bone in a young runner. A detailed history is vital in making a differential diagnosis and a diagnosis supported by investigations to provide a structured treatment plan. The most common causes of forefoot pain in athletes are metatarsal stress fracture, sesamoid pathology, metatarsalgia, hallux valgus, and turf toe. Leonardo da Vinci described the foot, an area of the lower extremities with a complex anatomy and biomechanics, as a “masterpiece of engineering.” However, forefoot injury often results from acute trauma or chronic overuse in athletes who participate in high-impact sports that involve running and jumping. The pain was alleviated significantly, and the patient resumed regular physical activity. The patient was placed in a foot and ankle brace for 6 to 8 weeks and received physiotherapy, forefoot strapping, and orthoses. On the basis of the history and physical examination findings, stress fracture of the base of the first metatarsal bone was the diagnosis. Possible disorders included stress fracture of the base of the first metatarsal bone, Lisfranc ligament injury, extensor tendinopathy of the tibialis anterior tendon, synovitis of the metatarsal-cuneiform joint, and bone tumors. ABSTRACT: A 29-year-old white man who is an avid runner presented with a 2½-year history of left midfoot pain on the dorsal area of the first metatarsal-cuneiform joint.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |