Forefoot / Midfoot · Oncology · Advanced
Stubbed Toe
Podiatric surgery residency interview case. Work through it the way you would at an interview: take the history, ask for the exam and imaging, then commit to a diagnosis and plan.
Chief complaint
"I stubbed my toe three weeks ago and it still hurts."
60-year-old female seen in the podiatry clinic.
History of present illness
Stubbed her left 4th toe 3 weeks ago. Pain and swelling have continued rather than improved.
- Pain around the 4th metatarsal head
- Shooting pain to the top of the midfoot from the toe
- Elevation helps slightly; NSAIDs do not help
- Pain now present at rest and at night
- Unintentional weight loss of ~10 lb over 3 months and a chronic cough
Questions a strong candidate asks at this step
- Mechanism vs severity — is the pain out of proportion to the injury?
- Night pain, rest pain (red flags for tumor/infection)
- Response to NSAIDs
- Constitutional symptoms: weight loss, fatigue, night sweats, fever
- Cancer history and screening; respiratory symptoms
Present the rest of the case
Past history, exam, imaging, assessment, plan and discussion questions, with model answers, are in the interactive trainer. The diagnosis is kept there on purpose so you can practice committing to one.