Weird Problem With A Toe

"Arrows added for emphasis. Not included with machine."​

Who designs this stuff??? I was gonna reply with a pic of my urodynamics machine, but there are lots of varieties and none of them fully resembled mine. Even so, the pics made me curl up in the fetal position.

Interesting that the source of your pic is "DenseBreast-Info.org" I saw posters last night extolling the benefits of MRI exams for women with dense breasts to augment regular mammograms.

 

So I just got the MRI results via the online health account some of us have these days. I bet doctors loathe this stuff, since they lose control of giving the results and of providing a context. I guess he'll call me to come in and discuss the next step.

It says "No Abnormalities." This is weird. The stabbing and discomfort have been spreading and getting more frequent. I would assume that nerve issues will be the next thing to be looked at, although the podiatrist said "There's something in there" during the exam, but we immediately transitioned to discussing the MRI. I did not get a chance to ask (a) do you see something, (b) do you feel something, or (c) is that a conclusion based on my symptoms.

I don't think there's a foreign object in there because the "feels like a sharp needle" is in the pad of the toe, then along the side of the toe, then the top of my foot. Although it's only in one spot at a time, there's no way it could move that far in that quickly, only to return to it's exact starting point. And it's always in the exact same place at each pad/side/top location. And it's gone from occasional discomfort to nearly constant discomfort.

I don't have a fever, and the MRI says it's nothing serious. So I guess there's nothing major wrong.

 

I was thinking the same thing, Nancy. And it makes sense, because the stabbing is always in the exact same spots. In checking out the various methods of foreign body detection, I came across the following info on Radiopaedia.org an "open-edit radiology resource, compiled by radiologists and other health professionals from across the globe." Interesting comment there on using MRIs to detect foreign objects. I guess the doctor suspected either a bone problem or some soft tissue issues when he ordered an MRI as the initial tool. Maybe a CT scan is next...or perhaps ultrasound.

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Plain radiograph
Only ~10% of x-rays ordered for investigation of retained foreign bodies are positive (reflecting the low incidence post-injury), but x-rays are excellent at detecting radiopaque foreign bodies with ~85% being detected 6:

• glass is always radiopaque, independent of lead content or other additives, with the caveat that tiny pieces may be too small to actually be resolved (see below) 7,8
• should be visible on plain films if larger than 2 mm 2,5,10

CT
All glass is visible on CT and usually easier to see than on plain radiography 9. Density varies between 500-1900 HU. Dense fragments as small as 0.01 mm3 can be detected 10.

Ultrasound

• can be used to localize foreign bodies further and define the relationship with soft tissue structures and assess for further injuries
• appears hyperechoic with posterior acoustic shadowing and often demonstrates reverberation artifact 10
• if present for >24 hours may demonstrate a hypoechoic ring 3,4

MRI
MRI would clearly not be the first choice investigation for detecting foreign bodies, including glass. Nevertheless, on MRI all forms of glass are seen but on most sequences considerable artifact is present 9.

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I went in for the follow-up. The podiatrist says to take a Wait & See position. The MRI ruled out tumors, bone infections, and other bad stuff.

I like this guy. "No need to go in and take a look. Why cut you open for something that's a minor irritant and that we might not even be able to find?" So I have an appointment to go back in 6 months and see how things are. If need be, we'll do a CT scan then to specifically look for an object.

The thing he noticed when I was in there last time was a slight bulb of flesh on the bottom of that toe. THAT'S what I feel when I step off of it.

It's always something...

 

I gotta bite the bullet. I can't go 6 months in a reduced mode. It'll get better or I'll break it.

So how is the jumping going, Gloria? It sounded like immediate initial progress.