Forefoot / Midfoot · Arthritides & Derm · Medicine & Peri-op · Standard
Aching Feet
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 feet hurt — especially the balls of my feet."
40-year-old female seen in clinic.
History of present illness
Moderate pain in both feet, worst under the "balls of the feet", and also in the arches and ankles.
- Gradual onset over several years, progressively worse; feels like "walking on pebbles"
- Morning stiffness lasting over an hour
- Tried sneakers and OTC orthotics without success
- Takes ibuprofen 800 mg with minimal relief
- Also reports numbness and tingling in both feet
- No trauma, no open wounds
Questions a strong candidate asks at this step
- Onset, duration, progression, which joints
- Morning stiffness and its duration (> 1 hour = inflammatory)
- Character: 'walking on pebbles' (plantar MTPJ subluxation)
- Treatments tried: shoes, orthoses, NSAIDs, injections, DMARDs
- Numbness/tingling, wounds, swelling
- Function: walking distance, ability to work
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.