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Clinical and Medical Imaging Findings of the Forefoot Following a COVID-19 Infection: A Case Report

Dominick Casciato OhioHealth Grant Medical Center, Columbus, OH.

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Randall Thomas OhioHealth Grant Medical Center, Columbus, OH.

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Joshua Houser OhioHealth Grant Medical Center, Columbus, OH.

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Since the beginning of the SARS-CoV-2 pandemic, manifestations of the COVID-19 virus have been reported throughout the body, visible both clinically and radiographically. In the foot and ankle, one such phenomenon presents as cutaneous changes associated with neuralgia to the digits. Although rare, emerging reports described similar manifestations of COVID-19 in the foot, though limited to superficial structures. In this case report, we present a 52-year-old male experiencing burning pain and hyperpigmented lesions to the digits of his left foot 2 weeks prior to a formal diagnosis with COVID-19. Advanced imaging showed a third interspace neuroma as well as distal-to-proximal bone marrow edema in the distal phalanx of all digits, a pattern seen in vasculopathies, 4 weeks after diagnosis. In the absence of diabetes mellitus or peripheral vascular disease, the patient underwent a simple neurectomy. At the follow-up appointment 12 weeks after the initial encounter, his symptoms resolved. Our study reports a case describing osseous along with cutaneous manifestations in the foot of a patient with COVID-19.

Corresponding author: Dominick Casciato, DPM, OhioHealth Grant Medical Center, Columbus, Ohio 43215. (E-mail: dominick.casciato@ohiohealth.com)
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