Differential Diagnosis for Left Ankle/Heel Pain
Single Most Likely Diagnosis
- Plantar Fasciitis: This condition is characterized by inflammation of the plantar fascia, leading to pain in the heel and bottom of the foot. The pain often worsens after periods of rest, such as sleeping, and can be relieved by stretching or changing positions, which could explain the relief when propping the leg over the other.
Other Likely Diagnoses
- Achilles Tendinitis: Inflammation of the Achilles tendon can cause pain in the back of the ankle, which may worsen at night and improve with certain positions or movements.
- Peripheral Artery Disease (PAD): While less common in the ankle, PAD can cause pain in the legs that improves with dependency (hanging the leg down) or certain positions, which might be misinterpreted as relief from propping the leg.
- Nighttime Foot or Ankle Cramps: These can cause significant pain and might be relieved by changing positions or stretching.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although DVT typically presents with swelling, redness, and warmth of the affected limb, it can sometimes cause pain that changes with position. It's crucial to consider DVT due to its potential for severe complications, such as pulmonary embolism.
- Osteonecrosis or Avascular Necrosis of the Talus or Calcaneus: These conditions involve the death of bone tissue due to a lack of blood supply and can cause severe pain that might change with position or weight-bearing status.
- Infection (Osteomyelitis or Septic Arthritis): Infections in the bone or joint can cause pain that is constant and severe, potentially worsening at night, and it's essential to identify these conditions early due to their potential for serious complications.
Rare Diagnoses
- Tarsal Tunnel Syndrome: This is a rare condition that involves compression of the posterior tibial nerve as it travels through the tarsal tunnel on the inner side of the ankle, leading to pain, numbness, and tingling.
- Bony or Soft Tissue Tumors: Although rare, tumors in the foot or ankle can cause nocturnal pain and should be considered in the differential diagnosis, especially if the pain is persistent and unexplained by more common conditions.