[32F] With injured second toe post-treadmill accident

Patient Description

A 32-year-old female with a history of asthma, vitamin D deficiency, Cushing syndrome, diabetes, hypothyroidism, a lump, tooth decay, and white patches, presented with an injured second toe after hitting it on a treadmill a day ago. The injury caused bleeding and throbbing pain, which lasted for a few minutes. The patient reports minimal swelling and is able to move the toe. The toenail appears discolored with some redness under the top of the nail. The patient has not noticed any signs of infection such as increased redness, warmth, or pus. Current medications include Levothyroxine 0.075mcg daily, Lantus Solo Star 60 units once daily, Simvastatin 20mg once nightly, and Trulicity. No known allergies.

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Arora's Assessment

What might be happening

Based on the information you have provided and the image of your injured toe, here are some possible explanations:

  • Toenail Trauma: The discoloration, redness, and bleeding around the cuticle area suggest that you have experienced trauma to your toenail. This can cause bruising (subungual hematoma) and may result in a darkened appearance under the nail.

    • Treatment: Typically, minor toenail injuries heal on their own. Keeping the toe clean and protected is important. Over-the-counter pain relievers can help manage discomfort.
  • Fungal Infection: The yellowish discoloration of your toenail suggests a possible fungal infection (onychomycosis). Fungal infections can cause the nail to become thickened, discolored, and brittle.

    • Treatment: Antifungal treatments, such as topical creams or oral medications, can be prescribed by a doctor. Keeping the feet dry and clean is essential to prevent further fungal growth.

What you can do

  1. Keep the Area Clean: Gently clean the injured toe with soap and water. Dry it thoroughly to prevent infection.
  2. Protect the Toe: Wear open-toed shoes or loose-fitting footwear to avoid further trauma to the toe.
  3. Apply Ice: If there is swelling, apply an ice pack wrapped in a cloth to the injured area for 15-20 minutes several times a day.
  4. Use Antifungal Cream: If you suspect a fungal infection, over-the-counter antifungal creams may help. However, consult a doctor for a proper diagnosis and treatment plan.
  5. Monitor for Infection: Keep an eye on the injury for signs of infection, such as increased redness, warmth, pus, or worsening pain.
  6. Rest: Avoid activities that put pressure on the injured toe to allow it to heal.

What you should look out for

Seek medical attention if you notice any of the following:

  • Increased Pain or Swelling: If the pain or swelling worsens despite home care.
  • Signs of Infection: Such as increased redness, warmth, pus, or a foul odor.
  • Difficulty Walking: If the injury affects your ability to walk or perform daily activities.
  • Persistent Discoloration: If the discoloration does not improve or worsens over time.

Remember, while these tips can help manage your symptoms, it is important to consult a healthcare professional for a formal diagnosis and appropriate treatment. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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6 mo ago

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People Also Ask


What are the signs of a toenail fungal infection?

Signs of a toenail fungal infection include yellowish discoloration, thickening of the nail, brittleness, and sometimes a foul odor. The nail may also become distorted in shape.


How can I differentiate between a toenail injury and a fungal infection?

A toenail injury often presents with immediate pain, bruising, and discoloration due to trauma, while a fungal infection develops gradually with yellowing, thickening, and brittleness of the nail. A healthcare professional can provide a definitive diagnosis.


What are the best practices for managing a minor toenail injury at home?

For managing a minor toenail injury at home, keep the area clean and dry, protect the toe with open-toed or loose-fitting shoes, apply ice to reduce swelling, and take over-the-counter pain relievers if needed.


When should I seek medical attention for a toenail injury?

Seek medical attention if you experience increased pain or swelling, signs of infection such as redness, warmth, or pus, difficulty walking, or if the discoloration persists or worsens over time.


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