Differential diagnosis of inferior heel pain
Causes relating to plantar fascia:
- plantar fasciitis - by far the most common cause of pain below the heel
- rupture
- enthesopathies
Causes relating to soft tissues:
- fat pad atrophy
- heel bruise - bruised heel syndrome
- subcalcaneal bursitis
Causes relating to bone:
- calcaneal stress fracture
- primary and secondary tumours
- Paget's disease
- infection
- gout may rarely present as otherwise typical plantar fasciitis (1)
Causes relating to nerves:
- tarsal tunnel syndrome
- trapped abductor digitii quinti nerve
- sciatica radiculopathy (S1)
Reference:
- ARC (February 2004). Hands On - Practical advice on management of rheumatic disease, 2.
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