Forefoot / Midfoot · Pediatrics · Reconstructive · Standard
Sneaker Pain
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
"Her 4th toe hurts and looks different."
11-year-old female brought to clinic by her mother.
History of present illness
Mother is concerned about her daughter's abnormal 4th toes and, more specifically, pain in them. The child has had discomfort for about 2 weeks, aggravated by wearing sneakers, located mostly in the center of the forefoot. Her activity level has noticeably decreased because of it.
- The 4th toes were first noticed to be short and deformed around age 4–5
- No history of injury or trauma
- No numbness, redness or open lesions
Questions a strong candidate asks at this step
- Onset of the deformity and when it was first noticed
- Location and character of pain; shoe-gear aggravation
- Effect on activity; cosmetic concern
- Trauma, infection or surgery to the foot (acquired causes)
- Associated syndromes or other skeletal anomalies
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.