Causes
Inflammation of the forefoot, midfoot and hindfoot can have many different causes. In principle, an inflammation of the foot can have its origin in pathogens such as bacteria, fungi and viruses. Autoimmune diseases such as rheumatoid arthritis and so-called reactive arthritis, which can occur as a result of a bacterial infection of the gastrointestinal tract, the urinary tract or the sexual organs, can also play a role.
However, inflammation can also be caused by gout. This is a metabolic disease that originates in an accumulation of uric acid crystals in the joints. In an acute attack of gout, for example, it is usually mainly the metatarsophalangeal joint of the big toe that is affected and leads above all to severe pain during rolling movements.
Chronic joint degeneration (arthrosis) can also sometimes become inflamed and then lead to severe pain and discomfort. In case of a nail bed inflammation of a toe, the inflammation is mainly located in the area of the tip of the toe. Bacteria, viruses or fungi can penetrate the nail bed through open areas and lead to a pronounced inflammatory reaction and spread to other parts of the foot.
The causes of such a lesion are manifold. Among others, incorrect foot care, chemicals, cuts and injuries as well as pressure points can cause injuries to the foot. Common and known pathogens that lead to nail bed inflammation are bacteria such as staphylococci and streptococci, herpes viruses and yeast fungi.
The most serious form of nail bed inflammation is an inflammation caused by the bacterial germs staphylococci and streptococci. Basically, a superficial inflammation must be distinguished from a deep inflammation. In case of a purely superficial infection, local antiseptic therapy with creams is sufficient.
As soon as an infection reaches deeper, antibiotic or surgical therapy must be carried out. People with a weak immune system are particularly affected by such a deep bacterial inflammation of the nail bed. In this case, diabetes mellitus (diabetes) can often be found in the previous history.Even in the case of nail bed inflammation caused by yeast fungi, the majority of patients have a poorly controlled diabetes mellitus in their history, which provides an optimal breeding ground for these fungi.
Herpes viruses, on the other hand, once they have entered the body, remain there for a lifetime. Situations in which the body is exposed to increased stress, illness or even UV radiation cause these viruses to proliferate with symptoms. Inflammation of the foot can also be caused by pressure points (decubitus) in the heel area, which often occur during prolonged bed rest if the heel is not adequately protected prophylactically.
Pressure points with ulcer formation (ulcer formation) should also be mentioned here, which can often be caused by shoes that are too tight in patients with peripheral nerve damage caused by diabetes mellitus or also by peripheral arterial vascular disease. These ulcers can then become inflamed by colonization with skin germs. Diagnosis is based on an interaction of medical history, laboratory diagnostics, physical examination and imaging.
The first step is to find out the symptoms. It is important to find out when the symptoms began, how intense they are, whether they occur frequently and whether resting will alleviate the symptoms. These questions help the examiner to narrow down the number of possible illnesses.
This is followed by a clinical examination of the foot. During this examination, particular attention is paid to external changes such as redness, swelling, wounds or pressure points. The next diagnostic step is usually followed by a laboratory chemical examination of the blood, which includes an examination of the inflammation values such as the C-reactive protein (CRP), the blood sedimentation rate (BSG) or the leukocytes (white blood cells).
In addition, radiological methods such as conventional x-rays, magnetic resonance imaging (MRI) or computer tomography (CT) can also be used. If nail bed inflammation is responsible for foot complaints, a smear test can be used to identify the pathogen. If this is not possible, a so-called culture can be made, which allows the pathogens, if any, to multiply.
