Laboratory studies:
Although different clinical appear injuries of the firstmetatarsophalangeal joints, gout presents with pain in the firstfinger. Testing the level of uric acid, erythrocyte sedimentation rateand C-reactive protein may be useful to exclude gouty arthritis andother rheumatologic conditions. In other cases, laboratory studiesto evaluate metatarsalgiei benefit.
Imaging Studies:
Supravehgere radiography is indicated as initial imaging test andmay be helpful in excluding other etiologies of foot pain. It is recommended that serial radiographs and scintigrame to excludestress fracture. Ultrasound brings useful information on possiblepathological condition that may be responsible for the metatarsalregion of the foot pain, including bursitis, neuroma and jointeffusion. Magnetic resonance imaging is an important way,noninvasively detect and diagnose many causes of pain in themetatarsal region including conditions caused by trauma,circulatory disorders, arthritis, neuropathy and mechanicaldisturbances.
The differential diagnosis is made with the following conditions:metatarsal stress fracture, arthritis, avascular necrosis, goutyarthritis, deformation of the hammer toes, Lyme disease, NeronMorton, neuropathic plantar ulcers, osteomyelitis, sesamoidita,synovitis.
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