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Painful knot on the foot , history of thrombocytopenia and ITP - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1638 Questions
User :   I have a knot on the top of my foot that's been there for a few days. I've used Icy Hot, heating packs, ice packs, Mineral Ice rub and soaking in epsom salt and it has not improved, in fact, it's more painful. It's getting to the point to where I'm in excruciating pain when I walk. It doesn't hurt when I touch it but it hurts a great deal when I apply pressure! I haven't suffered from any injury, so this may be due to my Lupus. What should I do? I think I really need crutches or something!
Doctor :   hi
Doctor :   Dr. XXXXXXXX here.
User :   Good evening Dr. XXX.
Doctor :   let me read what you have typed.
Doctor :   how did the knot appear?
Doctor :   was there any injury associated?
User :   I'm not sure why or how I got it. I haven't suffered from any injuries. All I remember is that I came home from school one day and realized that my foot was hurting so I stopped wearing sneakers for awhile and tried methods to stop the pain and try to make the knot go down but it's just hurting worse.
Doctor :   is there any alteration in the sensation over the foot?
User :   Not that I know of. It doesn't hurt when I touch it or push on it but it hurts when I put weight on it.
Doctor :   ok. is the touch sensation affected?
User :   I'm not understanding what you mean by that.
Doctor :   i mean to ask, whne you touch att he affected place?
Doctor :   do you feel same sensation as elsewhere
Doctor :   or is there numbness or tingling associated?
User :   Everything feels the same throughout my foot. No tingling or numbness or anything. But sometimes there's throbbing where the knot it and it kind of hurts sometimes.
Doctor :   ok. then the possibility of nerve getting involved is not there
Doctor :   the knot is probably due to a muscle pull
Doctor :   get it examined by your healthcare provider/sports medicine person, to see what the cause could be
Doctor :   continue with the ice packs and the topical application of analgesic craem
User :   Okay. Would I be able to get some kind of crutches or something? Being that I'm a college student, walking around campus is very painful and very hard.
User :   Would this injury qualify for me to have these?
Doctor :   it will depend on the examination findings and teh severity of teh problem
Doctor :   you might need complete rest too until it goes away such that no pressure is put on your foot
User :   Okay. I think I may go to the ER tomorrow to see if there is anything they can do until I can see my doctor on Monday.
Doctor :   yes, it is better to take urgent opinion now since the pain is severe
Doctor :   are you on any oral medications for the pain?
User :   No sir. I'm not allowed to take over the counter medication for pain because I have an issue with my blood platelets and my doctor recommends that I only used prescribed pain meds so I have no relief of my pain.
Doctor :   ok. keep the foot elevated. avoid putting weight on the foot
Doctor :   and visit your doctor as early as possible for the painkiller prescription
Doctor :   is there any color changes or changes in skin over the knot?
User :   No everything looks the same, just a lump on the top of my foot.
Doctor :   ok.
Doctor :   may i ask what platelet disorder was diagnosed for you?
User :   I believe it is thrombocytopenia.
User :   And Idiopathic thrombocytopenic purpura. I'm not sure if that's the same thing or not.
Doctor :   ok. when was your last follow-up visit for these?
Doctor :   if teh counts are very low , then possibility of muscular bleed cannot be ruled out for the painful knot that you are having
User :   July 8th. I have to go back to get my platelets checked in 2 more weeks.
Doctor :   do not delay your visit to your doctor.
User :   I'll definitely contact my doctor as soon as possible. Thank you so much for your help Dr. XXX.
Doctor :   is there anything else I can help you with?
User :   I think that is all. I'm only having an issue with my foot but I'll definitely go and have someone look at it just to be sure nothing serious is going on.
Doctor :   sure. thanks for consulting me. bye for now.
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