Making a diagnosis with limited information and no direct examination is always challenging. Were X-rays taken at the hospital? Sometimes a small or "hairline" fracture may not be apparent on initial X-rays. Sometimes evidence of the healing fracture is more apparent on X-rays a couple of weeks after the injury. An MRI may also be needed if the pain does not resolve with treatment since injuries to cartilage, tendons, and ligaments are not seen on X-rays. A turf toe injury is a possibility as well. I would advise seeing a podiatrist in your area for further care.

Palmer Branch, DPM

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These appear to be warts which are a viral infection of the skin. The medical term for a wart is a verruca, or verrucae if there are more than one. There is typically nothing you did or failed to do that allowed these to occur. The viral infection is at the living deep layer of the skin called the dermis. The skin on the bottom of the foot is very thick since it is were we bear weight, so warts in this area of the body can sometimes be difficult to resolve with over-the-counter treatments. The terms "plantar warts" just refers to warts on the bottom of the foot, called the plantar surface. If nothing over-the-counter works, then go see a podiatrist to have them treated.

Palmer Branch, DPM

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There could have been a small fracture present. This may or may not now be visible on X-rays. There may have been an injury to a tendon on the top of the foot. The best way to know what the problem is and how to treat it is to see a specialist in foot and ankle problems, which would be a podiatrist.

Palmer Branch, DPM

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As several other doctors have mentioned, it is difficult to provide a diagnosis without an examination or even a picture. Often times an injury to the nail will cause a temporary stoppage of growth of the nail resulting in a line across the nail. If there is bleeding under the nail, then the nail can become discolored and raised. A minor injury to the toenail such as from stubbing the toe against a wall or wearing shoes that are too tight and press on the nail can also cause bruising under the nail. Major injuries to the nail can cause the nail to grow abnormally, but there is no mention of such an injury. A fungal infection of the nail cannot be excluded and an injury to the nail can sometimes make it easier to get a fungal infection of the nail. It is often wise to treat the nail with a prescription antifungal medicine to prevent a fungal infection when the nail is separated from the underlying nail bed. It does take 6 months or more for a nail to grow from root to tip, so improvement in the nail even with treatment will be slow. You should see a podiatrist to get a definitive diagnosis and the most appropriate treatment recommendations.

Palmer Branch, DPM

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If the doctor you mentioned was just your Primary Care Physician, then I would advise seeing a board certified podiatrist in your area. It is difficult to give a definite diagnosis or the be sure of the exact structures that could be involved without an exam. There may be a partially or completely ruptured tendon in the foot or ankle depending on the location of the pain and swelling. Another possibility is an injury to the cartilage of a bone in the ankle joint called the talus. This type of problem is called an osteochondral lesion. An MRI may be needed, but the MRI should be ordered by a specialist in the foot and ankle such as a podiatrist to be able to identify the anatomic structures that might be damaged which is helpful to the radiologist reading the images.

Palmer Branch, DPM

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I am not sure what you mean by a "cat's paw" on your foot. Typically, a shooting pain is due to a nerve problem or a tendon problem. In the area around the second toe, common causes of pain involve the flexor tendon below the toe that can get inflamed (tendinitis) or a fibrous plate (flexor plate) attached to the tendon can rupture. There also can be problems with the nerves in the area such as a neuroma (basically a thickened, scarred nerve). I would advise seeing a podiatrist in your area if over-the-counter medicines do not provide relief.

Palmer Branch, DPM

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This may be from a rash such as Athlete's foot (fungal infection of the skin), a contact allergy (possibly from leather dyes or adhesives in one or more pairs of shoes, or rarely a bacterial infection of the skin. If the toe is becoming progressively more red and swollen, then a more serious infection may be present and you should get immediate medical attention. If over-the-counter hydrocortisone or antifungal medication is not helping, then get an examination from a board-certified podiatrist.

Palmer Branch, DPM

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Given the very limited information, the ability of any physician to provide an accurate diagnosis is also going to be very limited. Typically numbness is a sign of a neurologic (nerve) condition, but circulation problems and other conditions can also initially present with numbness in addition to other findings. Classically, one of the first signs of diabetes can be numbness of the feet. In this case, there is nerve damage due to a physiologic condition that damages the nerve. Certain types of anemia, vitamin deficiencies, and lead poisoning are other examples. Other conditions that can produce numbness in the toes and ankle are due to a physical problem and can include a pinched nerve root in the spine (radiculopathy) or in the hip area (sciatica). There is a condition called tarsal tunnel syndrome which is similar to carpal tunnel syndrome in the wrist where a nerve in the ankle is compressed under a large ligament. There is no mention of any pain in the foot or elsewhere in the body as well as any history of medical problems that may help guide the determination of the condition as well as the treatment. I would suggest scheduling an examination with either your primary care physician (e.g. internal medicine or family practice) to check for diabetes and then a board-certified podiatrist to evaluate for any physical problem that may be the cause of the symptoms.

Palmer Branch, DPM

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To give a definitive diagnosis without an proper thorough exam is a challenge and can be misleading. Typically chronic foot deformities such as this are more readily corrected with conservative treatments at a younger age. Such treatments might include use of special adjustable braces or splints as well as casts. There may still be some ability to achieve some limited correction at age 5, depending on the exact nature of the problem. I would agree with my colleagues that more success is seen in conditions such as metatarsus adductus where the bones just behind the toes are angulated toward the midline of the body. To find out the most optimal treatment options for your child's foot problem, I would recommend you go to a board-certified podiatrist. Surgical treatments are usually done only if conservative treatments fail and typically not this young.

Palmer Branch, DPM

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I agree with the other doctors who have responded in that making an exact diagnosis with a limited description is difficult. It is not clear whether this "bump" is in the skin or soft tissues below the skin. For that matter, depending on exact location, this could even involve the bones around the arch. This may or may not have anything to do with the increased activity from the basketball conditioning. If is is a problem in the soft tissues, this could be a chronic partial tear of a tendon (e.g. the tibialis posterior tendon) or ligament (e.g. the plantar fascia in the arch), or an unrelated soft tissue mass of some kind. Getting a formal evaluation by a podiatrist in your area would be a great place to find out what the problem is and how to treat it.

Palmer Branch, DPM

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I assume you mean the "history of ulcers in your family" refers to ulcers (wounds) on the feet and legs. The "dark rough patch" on your ankle could be a sign of a circulatory problem, either from the arteries or veins. There are several conditions involving the arteries and veins which can produce areas of discolored and/or inflammation of the skin. The patch could also be something completely unrelated such as a chronic inflammatory skin problem (e.g. eczema or contact allergy). It also could be something more serious. Without a picture or formal exam, any diagnosis or treatment plan would be very likely to be inaccurate. First and foremost, have it formally evaluated by a doctor - either a podiatrist, dermatologist, or vascular surgeon to see what testing and treatment would be most appropriate.

Palmer Branch, DPM

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Typically, a dislocation refers to where the bones involved in a joint are shifted significantly out of their proper alignment to the point where the joint cannot function properly. I assume you are referring to a dislocation from a recent injury. Such dislocations can happen to small joints, such as in a toe or larger joints, such as the ankle. There may or may not be fractures of the involved bones. Joints are held in place by ligaments and other soft tissues. In most cases, for a dislocation to occur, there must be significant tearing of the supporting ligaments. Although it may be possible in many cases to put the joint back in the normal position by manipulating the involved bones back into position without surgery, this is not true in every case. The other concern is to be sure that the involved bones will stay in the proper alignment and the torn ligaments will heal properly to be sure the joint will not repeatedly dislocate. In cases of dislocations of a toe, if the toe bone cannot be successfully put back into proper position and maintained in that position without surgery, then placement of a metal pin may be necessary to stabilize the toe until it heals. This would need to be based on the evaluation and initial attempts at conservative treatment (if possible) by a doctor who treats such problems.
If this is a more chronic situation, then surgery typically is the only solution to get the toe back into position and have it maintained in that position.

Palmer Branch, DPM

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The answer would depend on what is actually there and exactly what surgical procedure is being done. If this is something you have diagnosed yourself without ever seeing a doctor, then a proper evaluation by a doctor who does surgery on the foot is definitely a good idea. Your problem may not even be something that requires surgery at all. Surgical removal of a small bone spur / bony prominence such as on a small toe is a very minor procedure. For this type of procedure, patients are typically able to walk on the foot immediately. Surgical removal of a bone spur in the Achilles tendon is far more involved and may involve being unable to bear weight on the foot for several weeks. To find out exactly what you need, make an appointment with a doctor who actually performs such surgical procedures to get detailed, exact answers to all the questions you may have. These types procedures are most commonly performed by a podiatrist.

Palmer Branch, DPM

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As noted by some of the other respondents below, a second opinion would be a good idea at this point. There are several possible reasons for the continued pain. I would suggest first examining to see if plantar fasciitis is truly the cause of pain. Other conditions can cause chronic heel and arch pain and mimic plantar fasciitis. One common possibility is tarsal tunnel syndrome which is similar to carpal tunnel syndrome seen in the wrist. Other possibilities include nerve entrapments (in the foot or low back), soft tissue masses, or stress fractures in the heel. There may be painful scar tissue or a nerve entrapped in scar tissue from the surgery. Even if a surgery is done perfectly from a technical standpoint, complications can happen on rare occasions. Although physical therapy can be considered as a component of treatment, I would first recommend a formal second opinion evaluation by a podiatrist who can order for additional diagnostic tests such as nerve conduction studies or an MRI if needed.

Palmer Branch, DPM

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I agree fully with the other doctors that the lesions should be evaluated by a podiatrist (or dermatologist) to get a definitive diagnosis and treatment plan. Excision of the lesions may be necessary, but other office treatments or prescriptions may be beneficial. All will depend on the formal in-person evaluation by the podiatrist (or dermatologist). Pictures and online discussion are typically not going to provide adequate information in this type of situation.

Palmer Branch, DPM

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There are a few different skin lesions that this could represent. One is a porokeratosis, which is a benign skin lesion with a hard plug of skin or core that can be quite painful. A small, atypical wart, also known medically as a verruca, can have a similar appearance. Old puncture wounds, atypical scars, and callouses can also have this type of appearance in some cases. If over-the-counter treatments have failed, see a podiatrist to see what more definitive treatments can be offered, depending on the diagnosis determined at the time of evaluation.

Palmer Branch, DPM

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To say there is fluid in your ankle brings up one big question: "Why is it there?" Excess fluid in a joint is generally due to some sort of inflammatory process such as arthritis, cartilage damage, or a fracture that has not healed. Many other options such as gout may be present. For that matter, the fluid may not be in the joint itself, but in a tendon or local fluid-filled cyst such as a ganglion cyst. A thorough examination by a specialist in foot and ankle problems, which is what a podiatrist is, would be indicated. X-rays and possibly an MRI would likely be indicated to determine the underlying cause and most appropriate treatment.

Palmer Branch, DPM

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