A 5-month-old boy was brought to his primary care physician after his mother had talked to the on-call nurse the evening before. The mother was concerned that the child’s toe appeared swollen and slightly red. The redness, which she noticed while bathing the child, had worsened overnight. The symptoms had been present for approximately 16 hours by the time the child arrived at the clinic.
There was no past significant medical history. More specifically, there was no history of foot abnormalities or infections. The child reportedly only wore socks or booties and had not worn new footwear.
There were 3 children in the family, which was well known to the clinic. There had never been any concerns of abuse or neglect in the family. The mother had commented at the last health maintenance examination that this child was her “easiest” child to care for.
Does this look like abuse to you, or a condition that mimics abuse?
