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The response to the question below was authored by Marc Mitnick DPM

8 days post operative bunionectomy with 1 st and 2 nd toe osteotomy.

by jennifer
(HHDS,NY,USA)

I tripped and landed on my foot going from no pain to severe pain at the the top and bottom of the foot near the 3rd,4th and fifth toe. i saw my doctor today and had a xray . i had noted dark purple red bruising on the bottom of foot,lateral side and heel with increased swelling. the doctor stated the xray showed to much swelling to identify a fracture at this time but, it is very possible i developed a stress fracture. He then put me in a fiber glass cast. my question is when he did the surgery he told me i had severe arthritis in my toes and more than what a 28 year old should have. would this predispose me to easily obtain a stress fracture and do all my symptoms fit a stress fracture.i also was diagnosed with arthritis in my hands and was tested for rheumatoid 4 yrs ago and was negative. should i be retested? My dr states that it could be many types of arthritis???


RESPONSE

Hi Jennifer,

Not to split hairs here but a stress fracture occurs when there is no history of trauma. Typically a person will come into the office complaining of pain, usually in the forefoot, for no apparent reason. An x-ray will then show a fracture.
In your case if you do have a fracture it is a traumatic fracture, meaning you injured the foot and now perhaps there is a broken bone.
I agree with what your doctor has proposed. He cannot see any break in the bone, initially. However, not all fractures always show up on the first x-ray, but apparently because of all
the bruising that has occurred, he is concerned in spite of the negative x-ray.
Putting you in a cast is what I would have done as well with the stipulation that I would do another x-ray in about ten days. At that point, if there is a fracture, it should be visible. It should be pointed out, however, that sometimes fractures are so small that the only way to identify them is through the use of a bone scan or an MRI. In most cases it becomes a moot point, because if there is a fracture that small, chances are it will heal uneventfully while you are in the cast.
In answer to your question I am not sure I see a connection between your supposed arthritis and a possible fracture. As your doctor stated there are other types of arthritis in addition to rheumatoid arthritis that could occur in someone in your age, so those of course should also be ruled out.
On the surface at least it just sounds like you tripped and really hurt yourself and any arthritis you may or may not have is incidental and not a contributing factor.
Now, if the injury you sustained happens to be way out of proportion to the actual trauma and it turns out you did break a bone, I might consider investigating whether or not you have a metabolic condition of some sort that may be causing your bones to be more brittle than they should be in a 28 year old. This would be something your doctor might consider since he is more familiar with your situation than I could ever hope to be.

Marc Mitnick DPM
DISCLAIMER

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

DISCLAIMER: The purpose of this site is purely informational in nature. It is not intended to diagnose, treat or cure any medical condition. This information is not a substitute for advice from a medical professional. Please consult your healthcare provider for accurate diagnosis and treatment. The information presented here may be subject to errors and omissions.


SITE LAST UPDATED: APRIL 2026




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(location unknown)
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(location unknown)
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(location unknown)
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(location unknown)
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Unknown location

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Unknown location

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Anonymous



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New Zealand

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Arizona
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Poland
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South Carolina
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Natalie

unknown location


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Arlington, VA


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San Clemente, CA


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Pam

location unknown


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location unknown


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Bre

location unknown


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anonymous



Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

anonymous



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Poland



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Seattle, WA


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Bonnie

location unknown



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New Jersey



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Debbie

location unknown



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Chrissy

location unknown



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Evansville, IA



Dear Marc

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Russ W.

location unknown



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location unknown



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Jackie

San Diego, CA



Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

Rivi,

Albany, NY



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Jill S.

location unknown



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Jackie

Whichita, KS



thanks again, this site is very helpful.

mark

Boston, MA



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Colorado



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annielou

Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown
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Canada
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location unknown
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Wisconsin
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Julie

location unknown
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Renae

North Carolina
Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida
Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown
Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey


Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown


I have read your website and I have to admit that I am amazed at all the information that is on here. I have learned more than the three years I have been going to several doctors that I have seen!!

Melody

Lenoir, NC


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Rustam

Bellevue, WA


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Jodi

location unknown

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