Progressive Plantar Foot Pain as a Presentation of Arteriovenous Malformation: A Case Report of Diagnostic Delay

Arteriovenous malformations (AVMs) of the foot are rare vascular anomalies that may present with nonspecific symptoms and mimic common emergency department conditions.We report a 26-year-old man with progressive plantar foot pain and swelling who had multiple healthcare encounters before an AVM was diagnosed.Initial evaluation included unremarkable radiographs, treatment for presumed cellulitis, and negative venous duplex ultrasonography for deep venous thrombosis.Persistent and worsening symptoms ultimately prompted targeted ultrasonography, which identified a plantar AVM.On subsequent emergency department presentation for severe pain and inability to bear weight, examination demonstrated a warm, exquisitely tender plantar lesion with pulsatile Doppler flow, and computed tomography angiography confirmed the diagnosis.The patient underwent transarterial embolization with subsequent improvement in pain, swelling, and ambulation.This case highlights the importance of reconsidering the differential diagnosis in patients with persistent or recurrent symptoms, particularly when clinical features are atypical for common conditions such as cellulitis or when abnormal vascular findings are present.