Solitary Presentation but Multiple Etiologies in Foot: A Case Series

The swellings of foot are common but the lesions of metatarsals are rare. The purpose is to highlight these four cases which had almost common presentations but had different etiologies.

A series of four cases all of which had similar presentation, but different etiologies. One case had foreign body (FB) granuloma, one had tibialis anterior (TA) tendinosis and the other two cases had osteomyelitis, one pyogenic and the other tubercular. All cases underwent curettage and removal of the pathogenic foci, and were diagnosed with tissue biopsies.

Clinical signs in tuberculous (TB) osteomyelitis, pyogenic osteomyelitis, FB granuloma, and tendinosis are generally subtle and lead in most cases to a late diagnosis. In developing countries, where most of the people walk barefoot, FB granuloma due to thorn prick should always be considered as a differential diagnosis. Although rare to find tendinosis of TA, TB osteomyelitis, pyogenic osteomyelitis, and FB granuloma of metatarsals, these conditions should always be considered as differential diagnosis along with tumors.