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Help--What's the next step?

Posted by Sandy P on 6/22/01 at 03:37 (051220)

Have left foot pain on bottom at ball of foot where toes connect. Hurts to walk or bend toes. Also have large callous in that area. Have right foot pain on top of big toe where bunion was corrected with screw.

Have seen two podiatrists who have different opinions. First doc said I had a neuroma on left foot, (with no tests--just x-rays) even tho neuroma wasn't located in normal place. He suggested cortisone injection which I refused and then he scheduled me for surgery. He ordered MRI for right foot, even tho he knew I had a screw in the right foot where bunion was repaired. MRI revealed nothing because of screw, (technician advised me of this as I was having the MRI) and now I must pay for a test that was useless.

Second doc said I have a long metatarsal? on second toe of left foot that is causing the callous and if cortisone doesn't quiet it down, surgery would shorten the bone and therefore eliminate the callous and the pain. He, too, has taken only x-rays and blood tests. He feels I may have cysts on right foot at big toe joint and arthritic changes, plus screw may be a factor.

Before I consider surgery, I will seek a third dr's opinion, the dr who did the bunion/hammertoe correction on right foot.

My question is, should I insist on an MRI/CT of left foot to see if I have more than one problem, ie, neuroma and long metatarsal; and should I request a CT scan on right foot to determine what is causing pain at the joint of big toe. (Have very little range of motion in big toe). I can't agree to surgery if I don't have proof of what is causing the pain in both areas. Please advise. Thank you.

Re: Help--What's the next step?

Dr. Zuckerman on 6/22/01 at 15:38 (051270)

Hi,

The right foot pain sounds like the pain is from the lack of motion in the big toe joint. The evaluation for this is done by a hands on examination of the joint. Feeling the joint and placing the joint thru a range of motion is the best determination. The other foot could be compensation from the pain and lack of motion in the joint that had bunion surgery done.

The swelling in the left foot could be a stress fracture from all of your weight bearing placed around from other painful area.

So what to do .

Rule out stress fracture.

Padding under the long 2nd metatarsal bone. Poor shoe gear could contribute to this problem The callus tells me that you are placing abnormal weight under the metatarsal bone.

Very difficult. to tell if you need surgery. The length of time and what treatment you have tried are very important as to whether surgery is necessary,

My gut feeling is that alot of your pain is coming from the arthritic bunion joint.

I hope that this is helpful

Re: Help--What's the next step?

Dr. Zuckerman on 6/22/01 at 15:38 (051270)

Hi,

The right foot pain sounds like the pain is from the lack of motion in the big toe joint. The evaluation for this is done by a hands on examination of the joint. Feeling the joint and placing the joint thru a range of motion is the best determination. The other foot could be compensation from the pain and lack of motion in the joint that had bunion surgery done.

The swelling in the left foot could be a stress fracture from all of your weight bearing placed around from other painful area.

So what to do .

Rule out stress fracture.

Padding under the long 2nd metatarsal bone. Poor shoe gear could contribute to this problem The callus tells me that you are placing abnormal weight under the metatarsal bone.

Very difficult. to tell if you need surgery. The length of time and what treatment you have tried are very important as to whether surgery is necessary,

My gut feeling is that alot of your pain is coming from the arthritic bunion joint.

I hope that this is helpful