What are the diagnosis and symptoms of Plantar Calcaneal Fat Pad (PCFP) syndrome?

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Last updated: February 19, 2025View editorial policy

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Differential Diagnosis for Plantar Calcaneal Fat Pad Syndrome

Single Most Likely Diagnosis

  • Plantar fasciitis: This condition is the most likely diagnosis due to its high prevalence and similar symptoms, including heel pain and tenderness, especially after periods of rest or activity.

Other Likely Diagnoses

  • Plantar calcaneal bursitis: Inflammation of the bursa located between the calcaneus and the plantar fascia can cause similar symptoms, including pain and swelling in the heel.
  • Fat pad atrophy: Atrophy of the plantar calcaneal fat pad can lead to pain and discomfort in the heel, especially in older adults or those with a history of steroid injections.
  • Heel pad syndrome: This condition is characterized by pain and tenderness in the heel pad, often due to repetitive stress or trauma.

Do Not Miss Diagnoses

  • Calcaneal stress fracture: A stress fracture of the calcaneus can cause severe heel pain and must be ruled out to avoid delayed diagnosis and potential complications.
  • Infection (e.g., osteomyelitis or septic bursitis): Infection in the heel or ankle can cause severe pain, redness, and swelling, and requires prompt diagnosis and treatment to avoid serious complications.
  • Tumor (e.g., benign or malignant): Although rare, a tumor in the heel or ankle can cause pain and swelling, and must be considered in the differential diagnosis to avoid delayed diagnosis.

Rare Diagnoses

  • Rheumatoid arthritis: This autoimmune disorder can cause heel pain and swelling, especially in patients with a history of rheumatoid arthritis.
  • Gout: Deposition of urate crystals in the heel or ankle can cause severe pain and swelling, especially in patients with a history of gout.
  • Seronegative spondyloarthropathy (e.g., psoriatic arthritis or ankylosing spondylitis): These conditions can cause heel pain and swelling, especially in patients with a history of seronegative spondyloarthropathy.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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