Differential Diagnosis for Heel Pain in an 8-year-old Boy
- Single most likely diagnosis
- B. Calcaneal apophysitis: This condition, also known as Sever's disease, is a common cause of heel pain in children, particularly during periods of rapid growth. The patient's age, increased pain during athletic activity, and tenderness at the base of the heel are consistent with this diagnosis.
- Other Likely diagnoses
- D. Plantar fasciitis: Although less common in children, plantar fasciitis can occur, especially in those who are overweight or have a history of repetitive stress on the heel. However, the absence of pain in the plantar fascia and the specific location of pain at the base of the heel make this diagnosis less likely.
- A. Achilles tendinopathy: This condition typically presents with pain and tenderness in the Achilles tendon, which is not the case in this patient. However, it can be considered in the differential diagnosis due to the proximity of the Achilles tendon to the heel.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- C. Juvenile idiopathic arthritis: Although this condition is less likely given the absence of pain in other joints and systemic symptoms, it is essential to consider it in the differential diagnosis due to its potential for severe consequences if left untreated.
- E. Tarsal tunnel syndrome: This condition is rare in children, but it can present with heel pain and should be considered in the differential diagnosis to avoid missing a potentially treatable condition.
- Rare diagnoses
- Infections (e.g., osteomyelitis, septic arthritis): These conditions are rare but can present with heel pain and swelling. They are essential to consider in the differential diagnosis, especially if the patient has a fever, redness, or warmth around the affected area.
- Tumors (e.g., osteoid osteoma, Ewing's sarcoma): Although rare, tumors can cause heel pain in children. A thorough evaluation, including imaging studies, may be necessary to rule out these conditions.