Third Metatarsal Chronic Problems

by Diane
(Sebring, FL, USA)

I hurt my right lower back in 2000 and because of the way I walk I tend to put alot of pressure on my left foot. In 2001 I began having problems with swelling and tenderness on the top of my left foot, Bending my toes either upwards or downwards casuses extreme pain and jumping in the foot. Since that time I have been diagnosed with a sprain, gout (ruled out) a third metatarsal stress fracture (found on an MRI), an imaging test with contrast showed a big red area of heat in the area,and Freiberg's disease.

The diagnoses have come from a variety of orthopaedics and podiatrists. I have been in a plaster cast, air casts, braces, and an Una Boot 60% of the period from 2001 to now.

Just walking can set this metatarsal off and I am again with redness and tenderness as well as some swelling. The swelling seems to be in the toes and ankle moreso then the top of my foot with some discoloration where my toes meet my foot. I was at the podiatrist office again today. X-rays were taken and this concerns me because the original stress fracture was not found with an xray and this Dr's xray equipment is dated. She said "no fracture", gave me 4 injections in the top of my foot and wrapped it "una boot style". She said the dx was Gout and I questioned her on this as I have had labs, urine and blood done recently by my other docs and nothing was out of kilter. She said she "knows it is gout" and put me on a very very strict "no eat or drink" list. She also gave me a script for Indomethacine which after reading the warnings the pharmacist gave me I will NOT take. This Dr is well aware of the fact that I cannot take NSAIDS due to a history of ulcers. A baby aspirin taken for 3 days had my stomach bleeding.

Trying to decide whether I should just go back to the orthopedic Dr I see fro my back and have an MRI done on the foot. I know there is nerve damage in there and this gout business does not seem to be the answer. This has been going on for 8 yrs now with ole Funky Foot and I would like a real diagnosis. Your thoughts?

Hi Diane,
I would certainly not go back to this particular podiatrist. How can she give you Indocin when she knows of your stomach problems?
A healed stress fracture will no longer show up on x-ray if it is healed and was originally a "small crack" to begin with.
Eight years of pain is a LONG time; you need to find a doctor who can think outside the box and try a different approach to your problem. Unfortunately I cannot give you any direction without actually examining you other than to advise you to ask around and try and get a recommendation from someone, the local hospital or other doctors that you go to.
Marc Mitnick DPM