Question
HI Marc,

Thanks for the reply. After visiting the 2nd doctor today ( podiatrist ) he told me that he thinks it is a accessory bone.  It is my second toe on my right foot on the underside near the joint.  The toe has gotten worse and is extrememly swollen still, he gave me a prescription for an anti inflammatory to help with it. It basically sounds like I have to make the decision whether or not to get it removed if it continues to be painful.  Is what he said possible in that it is not on the big toe?  
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The text above is a follow-up to ...

-----Question-----
HI,

For about two years I have had a hard bump on the underside of my toe, This has never caused pain or problems so I ignored it. I assumed it was from my 16 years of dancing that caused this somehow.  The last three days my toe has been swollen and  hurts to touch move etc, throbbing stabbing pains. I went to the doctor yesterday, took exrays that show a round something on the underside that doesnt look to be connected. Doctor said looks like bone, told me to take aleve , ice and come back in 3 weeks to talk to a surgeon to get it removed.  I have another app with another doctor tomorrow because I am not satisfied with that considering how much pain I am in.  Do you have any ideas, advice, questions I should be asking to help me out. I cant walk it hurts so bad, I want to know what it is and why its causing pain..........
-----Answer-----
Hi Carolyn,

I agree.  Waiting for 3 weeks and taking Aleve is not acceptable.  You are obviously in pain.  

It is possible but unusual to have a piece of bone under the toe unless it is the large toe.  Which toe is it and where on the toe is the bump?

If it is the large toe in the center/bottom, you may have a bone known as an accessory sesamoid or ossicle.  These occur in many people and may become symptomatic.

Other possibilities include, a cyst, commonly a ganglion cyst.  At times these can calcify and appear as bone.

I would see a Podiatrist and be evaluated.  You may get relief from a cortisone injection or padding.  You may require surgery for removal of the bone or cyst.  

In any case, you deserve more timely treatment and again a Podiatrist is the best specialist for this problem.

Good Luck

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.theTampaPodiatrist.com
http://www.TampaCryosurgery.com

Answer
Hi Carolyn,

There can be an accessory bone under any toe, however the smaller toes are less common and usually the extra bone is seen on several of the toes.

I have found that simple anti-inflammatories are not all that successful.

Regardeless of what is under your toe, you will likely need to decide if you want to have it removed.  If it continues to be painful and not relieved by simple treatment, you will likely get relief from having the small bone or cyst? removed from the toe.  After that the pathology report will tell what was found.

I would consider a cortisone injection before having surgery.  A small amount would be used in the toe and this could potentially stop the pain and inflammation and help you avoid surgery.  Some Drs. may be hesitant to inject an area with uncertain diagnosis.


Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.theTampaPodiatrist.com
http://www.TampaCryosurgery.com