Forefoot / Midfoot · Reconstructive · Arthritides & Derm · Core
Throbbing Big 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
"My right big toe hurts."
45-year-old female seen in clinic.
History of present illness
Several months of throbbing, aching pain at the right big toe joint.
- Location: medial bump of the right 1st MPJ
- Gradual onset, no trauma; progressively worse
- Worse in closed shoes and at the end of the day; better barefoot and with rest
- Pain 6/10; tried wider shoes and ibuprofen with partial relief
- No numbness or tingling; no redness or hot, swollen episodes
Questions a strong candidate asks at this step
- Onset, duration, progression; any trauma
- Exact location and character (throbbing, aching, sharp)
- Aggravating and relieving factors; shoe gear
- Treatments tried and response
- Red, hot, swollen episodes (rule out gout)
- Numbness or tingling (dorsomedial hallux nerve)
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.