Swollen and red? Stress fracture?

Ive been walking alot recently and now I have a sharp pain in my foot when I walk. Its by my 2nd and 3rd metatarsal. Im a13 year old girl and in pretty good shape, although Ive been lazy all summer. Does my foot look swollen or red to you? What dould this be from? A stress/march fracture maybe? Should I see a doctor?what will happen if it is a stress fracture?

http://i273.photobucket.com/albums/jj232...

It also hurts when touched.

Hello,

Wow, that is really helpful, thanks for the photgraph. You seem very clued-up on this.

Yes, there is a lot of swelling on the top of your right foot, as you say over the 2nd metatarsal, although it looks on the photogaph as though it's between the big-toe metatarsal (1st) and the 2nd-toe metarsal (2nd).

If it's a stress/march fracture, it will be painful if you press on the metatarsals from *underneath* your foot. Also it will be painful if you press on the metarsals by pushing on your big toe, then 2nd and then 3rd toes, towards your ankle. The painful toe will show which metatarsal it might be: there is one per toe, as you know.

If it is a possible stress/march fracture, you will need an X-ray and perhaps some other visualization technique, occasionally a bone scan, to confirm it. Then you will need to rest it up, at your age a fracture ought to heal real quickly.

An alternative diagnosis is 'tenosynovitis' of your long 'extensor' tendons. I will explain. The muscles which lift up your big toe and your other toes, are not in your foot, they are in the front of your shin. When you want to lift your big toe or other toes upwards, the muscles pull in the shin, but they only work because they are connected up to the top of your toes by a long thin 'tendon' or 'guider.'

If you walk a lot, your shin muscles work these tendons backwards-and-forwards backwards-and-forwards a lot, and although they run within lubricated sheaths, they can get sore after a while, and swollen up. Especially if you have not walked for a while, then suddenly walk a lot.

A sore, inflamed tendon is a condition known medically as 'tenosynovitis' (pronounced tee- noe - sye - noe -VYE'' -tis), also known as 'tendinitis.' Of the 'extensor' tendons, i.e. the tendons on the front of your shin, 'extensor tendinitis.'

It is quite common, and not as serious as a fracture. It will go down with rest and anti-inflammatory tablets.

The big toe has its very own extensor tendon, and the other toes have a common one, - please see the reference diagram below.

If it's this, then what is going to be most painful is actually using your muscles to lift or raise up your big toe or your other toes, because it's the tendons themselves which are sore. Putting pressure on the metarsals from different directions and angles than from the top, won't be painful.

Also, the tenderness will be a lot closer to the outside world, just under the skin in fact. Bone pain will be from a lot deeper inside.

I hope this is of some help.

Best wishes,

Belliger (retired uk gp)