Many patients with lesser toe problems can be advised on treatment (or none) without any investigations. Examples of situations when further investigation is useful include:
- possible inflammatory arthritis: FBC, ESR, CRP, urate, rheumatoid factor
- possible diabetes: fasting sugar; HbA1c to evaluate ongoing diabetic control
- possible neurological condition: CPK, spinal +/- cranial MRI, nerve condiction studies, nerve or muscle biopsy
- atypical toe deformity: AP/lateral +/- oblique plain radiographs of toe
- surgical planning for metatarsal osteotomy: standing AP/lateral plain radiographs of forefoot
- MTPJ instability: MR or ultrasound arthrography