Forefoot / Midfoot · Reconstructive · Pediatrics · Core
Toe Films
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 second toe is bent and it rubs on my shoe."
Adult patient seen in the outpatient podiatry clinic.
History of present illness
Gradual onset over several years of a bent second toe. Pain over the top of the middle toe joint when wearing closed shoes and under the ball of the foot with walking. A corn has formed and the toe no longer lies flat.
- Pain 4/10, worse in tight or narrow shoes, better barefoot or in sandals
- No acute injury; no numbness or tingling; no open wound or drainage
- Has tried padding and wider shoes with partial relief
Questions a strong candidate asks at this step
- Onset, duration and progression of the deformity
- Pain: location, severity, shoe-gear relationship
- Prior trauma, prior foot surgery (especially bunion surgery) or neurologic disease
- Numbness, tingling, weakness; wounds or drainage
- Prior treatments: padding, shoe change, orthoses
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.