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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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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

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Unknown location

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Poland

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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!

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Evansville, IA

Dear Marc

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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!

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Albany, NY

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Whichita, KS

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Boston, MA

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Colorado

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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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Wisconsin

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

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location unknown

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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

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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,

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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

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Lenoir, NC

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Bellevue, WA

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Jodi

location unknown

cellulitis or fracture

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