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Help - lump on toe

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  #1  
Old 24th November 2005, 09:40 PM
emoclew emoclew is offline
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Question Help - lump on toe

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Can anybody offer any prelim. suggestions for a lady that I will be seeing in a couple of weeks. She described her problem to me over the phone and I would like to have some d/dx for when she comes in. Last couple of years she has had a lump on her middle right toe which sweels up and fills with "pus" (a white exudate). Unless she expels this it gets very sore. The lump is dorsally. This si all the info I know so far.
Thanks anyone
Lisa
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  #2  
Old 28th November 2005, 06:39 PM
John Spina John Spina is offline
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Is this patient diabetic?If so,this sounds to me like diabetic bullae,which drains an aseptic fluid.If not it could be blisters related to shoegear or an ingrown nail w/paronychia.
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Old 29th November 2005, 05:17 AM
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Could also be a tophaceous gout. David M. Davidson, DPM
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Old 29th November 2005, 03:58 PM
John Spina John Spina is offline
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Dr.Davidson has a good point.Anyway,blood work and a complete H &P is the way to go.
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Old 29th November 2005, 08:20 PM
dr.morse dr.morse is offline
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If it is not a bullae and it is not gout it can be a ganglion. I just surgically resected a large 2.0 cm ganglion from the extensor tendon of the hallux after draining it 2x did not yield lasting results.

J. Morse, DPM
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Old 30th November 2005, 02:57 AM
emoclew emoclew is offline
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Thank you for your suggestions. I am seeing this lady tomorrow so your thoughts are sure to come in very handy.

Thanks again
Lisa
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Old 7th December 2005, 06:36 PM
emoclew emoclew is offline
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Hi,
thought I'd just update on the lump. The pt had popped the lump and said it did not look at all like a blister. When I saw it, it was red, but with no centre or head. Looked like there was some osteophyte below it. She's not diabetic. Very dorsiflexed digits so I made a simple felt dorsal pad to try to take the pressure off the area. She's very active and has developed this since upping her fitness regime on the treatdmill. I haven;t heard anything back yet.

Cheers
Lisa
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Old 7th December 2005, 11:00 PM
One Foot In The Grave One Foot In The Grave is offline
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I'd follow up for gout.
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