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History of Present Illness:

A 52-year-old male presents to the podiatrist for 4 years of worsening foot pain that is worse if he steps on a rock and that sometimes wakes him at night.    He denies any fever, trauma or other complaints.

Vital Signs & Physical Exam:

Vital signs are normal.  Physical exam is otherwise normal except for a lump in the middle of the right plantar arch

Initial Differential Diagnosis:

  • Giant cell tumor,
  • pigmented villonodular synovitis,
  • neuroma,
  • sarcoma,
  • scar/keloid,
  • fasciitis

Initial Diagnostic Testing:

  • Imaging: See ultrasound below

QUESTIONS:

  1. What does the case image show?  
  2. What should you do next?  
  3. Want a 1-minute consult/tutorial on this case? 
  4. Want to know what happened with this patient?

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ANSWERS:

  1. What does the case image show?  The image shows a plantar fibroma.
  2. What should you do next?  Refer to podiatry
  3. Want a 1-minute consult/tutorial on this case?  See yellow area from sample page below.
  4. Want to know what happened with this patient?  See case conclusion below tutorial page.

1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

CLICK HERE TO LEAR MORE ABOUT THIS BOOK

CASE CONCLUSION: MRI confirmed a plantar fibroma

MRI from 5 years prior

CASE LESSONS:

  1. Always
  2. Never
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