Forefoot / Midfoot · Pediatrics · Reconstructive · Standard
Soccer Bump
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 foot hurts by my big toe, especially when I play soccer."
8-year-old female seen in the office with left forefoot pain present for about a year.
History of present illness
Aching pain around the 1st MTPJ of the left foot for about a year.
- Pain increases after activity and is present while playing soccer
- No treatment has been attempted
- No trauma, no fever, no night pain, no other joint complaints
- Shoe wear is tight over the bump; no open lesions
Questions a strong candidate asks at this step
- Onset, duration, location, character of pain (aching, around the 1st MTPJ)
- Aggravating factors (activity, soccer, shoe wear) and relieving factors
- Prior treatment (none): shoes, padding, orthoses, NSAIDs
- Trauma or injury; fever, swelling, redness; night pain
- Associated symptoms: numbness, tingling, other joint pain, similar deformity in family
- Growth/puberty status, which sport and shoe type (cleats)
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.