| Five questions to guide assessment of trauma-related forefoot pain: |
- Does the patient recall acute hyperextension of the great toe followed by immediate or slightly delayed pain and swelling? — Suggests first MTP sprain ("turf toe").
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- Does the patient have persistent pain under the first MTP joint and a history of overuse or pressure in that region from shoes? — Suggests sesamoid injury or painful corn or callus (rarely, stress fracture of distal first metatarsal).
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- Is there discoloration and pain under the nail following direct trauma to the toe? — Subungual hematoma, possibly accompanied by fracture.
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- Is there tenderness, discoloration, and possibly malalignment of a toe following trauma? — Suggests toe fracture (or dislocation).
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- Is there swelling and tenderness over the dorsum of the forefoot (proximal to toes) after trauma or overuse? — Suggests metatarsal fracture or stress fracture.
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