Differential Diagnosis for Ankle/Foot Pain in a 10-year-old
Single most likely diagnosis
- Sever's disease (calcaneal apophysitis): This condition is a common cause of heel pain in children, especially during periods of rapid growth. It is characterized by inflammation of the growth plate in the calcaneus, which matches the patient's symptoms of foot pain and tenderness in the heel and ankle area.
Other Likely diagnoses
- Achilles tendonitis: Given the patient's complaint of pain going up the Achilles tendon, tendonitis is a plausible diagnosis. This condition involves inflammation of the tendon, which can cause pain and stiffness.
- Overuse injury or stress reaction: The patient's age and symptoms suggest a possible overuse injury, which can occur due to repetitive stress on the bones, muscles, or tendons in the foot and ankle.
- Plantar fasciitis: Although less common in children, plantar fasciitis can cause heel pain and is worth considering, especially if the patient has a history of increased physical activity.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Osteomyelitis or septic arthritis: Although the X-ray did not show any signs of fracture or dislocation, it is essential to consider the possibility of an infectious process, such as osteomyelitis or septic arthritis, which can have severe consequences if left untreated.
- Tumor or cancer: Although rare, it is crucial to consider the possibility of a tumor or cancer, such as osteosarcoma or Ewing's sarcoma, which can cause bone pain and swelling.
Rare diagnoses
- Tarsal coalition: A rare condition where two or more bones in the foot are abnormally connected, which can cause foot pain and stiffness.
- Freiberg's disease: A rare condition that affects the metatarsal bones in the foot, causing pain and stiffness.
- Köhler's disease: A rare condition that affects the navicular bone in the foot, causing pain and swelling.