Difference between revisions of "Ingrown toenail"
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==Background== | ==Background== | ||
| − | + | {{Fingertip anatomy}} | |
| + | *Lateral nail edge grows deep into nail wall → cycle of inflammation and hypertrophic granulation tissue can lead to abscess | ||
==Clinical Features== | ==Clinical Features== | ||
| − | + | [[File:Ingrown nail 002 cropped.jpg|thumb|Typical ingrown toenail]] | |
| + | *Pain and swelling at distal nailbed, typically unilateral | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
| + | ===Workup=== | ||
| + | *Typically does not require studies | ||
| + | ===Diagnosis=== | ||
| + | *Typically a clinical diagnosis | ||
==Management== | ==Management== | ||
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==Disposition== | ==Disposition== | ||
| − | + | *Outpatient | |
==See Also== | ==See Also== | ||
| − | + | *[[Ingrown toenail removal]] | |
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
| + | [[Category:Orthopedics]] | ||
Latest revision as of 17:18, 17 August 2019
Contents
Background
Nailtip Anatomy
- The perinychium includes the nail, the nailbed, and the surrounding tissue.
- The paronychia is the lateral nail folds
- The hyponychium is the palmar surface skin distal to the nail.
- The lunula is that white semi-moon shaped proximal portion of the nail.
- The sterile matrix is deep to the nail, adheres to it and is distal to the lunule.
- The germinal portion is proximal to the matrix and is responsible for nail growth.
- Lateral nail edge grows deep into nail wall → cycle of inflammation and hypertrophic granulation tissue can lead to abscess
Clinical Features
- Pain and swelling at distal nailbed, typically unilateral
Differential Diagnosis
Foot diagnoses
Acute
- Foot and toe fractures
- Subtalar dislocation
- Metatarsophalangeal sprain (turf toe)
- Acute arterial ischemia
- Calcaneal bursitis
Subacute/Chronic
- Diabetic foot infection
- Peripheral artery disease
- Plantar fasciitis
- Trench foot
- Ingrown toenail
- Paronychia
- Tinea pedis
- Morton's neuroma
- Diabetic neuropathy
Evaluation
Workup
- Typically does not require studies
Diagnosis
- Typically a clinical diagnosis
Management
- Minor cases can be treated non-surgically
- Others, preform partial ingrown toenail removal
Disposition
- Outpatient