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

cellulitis or fracture

by mike
(boston)

hi, the top of my foot, at the base of my toes,started becoming painful about six days ago. it kept getting more painful. i've been on keflex for three days after having been diagnosed at the ER with cellulitis. there was some redness running up my foot and my left foot was much redder than my right. the redness seems to have decreased, but the pain persists. i saw my PCP today and he suggested i check it out with a podiatrist. i was x-rayed at the hospital and no fracture was found. my understanding is that stress fractures are not always seen on standard x-rays. the pain is centered on the top of my foot at the base of the toe next to the big toe. if it is cellulitis should the pain have subsided with the keflex by now? i am still hobbled and in pain, especially when walking or flexing my toes. my foot has been mostly elevated for three days. i've also been taking three advils three or four times a day. thanks, mike


Hi Mike,

Most local cellulitis that I have ever seen in the area you describe is a secondary result of athletes foot from in between the toes. In other words there has to be an origin for cellulitis secondary to a bacterial infection. Do you fit into that category? If you do, and you have a true infection than the foot after three days should be feeling somewhat better (but usually not completely better); the problem is, simple cellulitis is usually not all that painful.
So, my next thought would be a stress fracture. You are right, they may not show up on initial x-ray, so they should be repeated in about ten days. If the second x-ray is negative and you are still having a lot of pain, an MRI might be indicated.
Lastly, redness on the top of the foot may be indicative of a superficial phlebitis. Make sure your doctor rules that out as well.
Good luck.
Marc Mitnick DPM

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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

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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.


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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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(location unknown)
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Denison, TX
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Texas
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Tampa, Florida 33624

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UK

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Mansfield Ctr, CT

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Placentia, California

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Unknown

Unknown location

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Unknown location

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Pacific Grove, CA

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Alameda, California

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Anonymous



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New Zealand

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Arizona
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Thanks, Kathy

Florida
1st of all THANKS A LOT for your great site......

Anna

Poland
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M P

South Carolina
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Natalie

unknown location


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Arlington, VA


Thank you so very much, that would be much appreciated. I love those insoles, by the way. (referring to Superstep orthotics)

Kelly W.

San Clemente, CA


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Pam

location unknown


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Glen

location unknown


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Bre

location unknown


Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

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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Bill

New Jersey



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Debbie

location unknown



Wow, that is exactly the information needed!!! thank you thank you thank you!!! I appreciate this help so very much from Marc Mitnick DPM. Excellent information and help to improve One's life.

Chrissy

location unknown



Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!

Tracy

Evansville, IA



Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

location unknown



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-Sunny.

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



Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown



THANK YOU SO VERY MUCH FOR YOUR TIME AND EFFORTS, YOU ARE SO VERY APPRECIATED. THANK YOU FOR ALL YOU DO.

Jackie

Whichita, KS



thanks again, this site is very helpful.

mark

Boston, MA



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....Keep up what your doing. Your a life saver.

Michelle

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
Again, I really appreciate that you responded to my inquiry, and that your mention of Parkinson's helped me to find my way to a diagnosis of this difficult to diagnose disease. Most patients see on average 16 doctors before they are diagnosed. I hope that you can help other people that ask for your expertise in the future.

Barb D.

Canada
I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......

Bonnie

location unknown
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Nancie

Wisconsin
Thank you for your response. You have provided some great insight (to my question)....

Julie

location unknown
Thank-you so very much for responding so quickly and in such detail to my question!! I will give my surgeon a call today!! This website is terrific!!!! Thank-you again!

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


Thank you so much Doc for a quick and thorough response!

Rustam

Bellevue, WA


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Jodi

location unknown

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