Ankle _ Foot Pain Mind Map.jpg

This clinical mind map is organized based upon the location of the pain. Although foot pain can be caused by numerous pathologies, determining the exact location and distribution of pain early on in the diagnostic process serves as a means to be able to arrive at the diagnosis efficiently. In conditions such as mallet toe, hammer toe, and claw toe, pain is limited to one or a few toes. Patients usually present with toe/toes pain as opposed to foot pain. Hence, these diagnoses do not belong to the foot and ankle pain mind map, but they are included here for thoroughness purposes.

When memorizing probable diagnoses, a clinician may notice that the anatomical location of pain correlates well with the diagnoses and their respective names. For example, metatarsalgia produces pain over metatarsals, tarsal tunnel syndrome produces pain in the tarsal tunnel area, plantar fasciitis causes most pain at the insertion of plantar fascia, bunions cause pain where these are formed, gout is commonly known to cause pain in the big toe, although additional areas may be involved, and all toe deformities cause pain in the respective toes involved.

There are very few life-threatening situations associated with foot pain. However, there are some diagnoses which should not be overlooked (complex diabetic foot infection, gangrene, and acute trauma) as these can lead to severe morbidity, and should be considered when looking for urgent/emergent situations. 

Overuse and/or subtle trauma has been associated with various causes of foot pain. Therefore, a thorough history should be obtained about work and daily activities. Knowing about laterality (unilateral or bilateral) of pain is helpful, as some conditions are typically unilateral, such as gout, cellulitis, and/or a fracture. The rest of the differentials can be unilateral or bilateral. A clinician should ask the patient to remove their shoes and socks early on in the history-taking process to simultaneously gather some physical exam-related data (inspection) and save time.