A 65-Year-Old Woman, Who Recently Relocated After Retiring, Comes to the Office

A 65-year-old woman, who recently relocated after retiring, comes to the office to establish medical care.  The patient has a history of hypertension, type 2 diabetes mellitus, hyperlipidemia, and osteoarthritis.  She does not monitor blood pressure at home and reports "fair" glycemic control with oral antidiabetic medications.  The patient does not use tobacco, alcohol, or illicit drugs, and formerly worked as a salesperson in a department store.  Blood pressure is 138/76 mm Hg and pulse is 82/min.  BMI is 34 kg/m².  Cardiopulmonary and abdominal examinations are unremarkable.  Foot examination reveals her 3rd and 4th toes appear "claw shaped," with dorsiflexion of the proximal phalanges at the metatarsophalangeal joints and plantar flexion of the proximal and distal interphalangeal joints.  Which of the following is the most likely cause of this patient's lower extremity findings?

A) Diabetic neuropathy
B) Foot osteoarthritis
C) Morton neuroma
D) Plantar fasciitis
E) Spinal stenosis

Correct Answer:

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