Differential Diagnosis for Knee, Shin, and Foot Pain after Starting to Run
Single Most Likely Diagnosis
- Overuse Injury or Shin Splints: This is the most likely diagnosis due to the sudden increase in physical activity, such as running. Overuse injuries, including shin splints (medial tibial stress syndrome), are common in individuals who start or increase their running routine without proper training or gradual progression.
Other Likely Diagnoses
- Runner's Knee (Patellofemoral Pain Syndrome): Pain around or behind the patella, often related to running, especially on hard surfaces or with poor footwear.
- Plantar Fasciitis: Inflammation of the plantar fascia, causing pain in the heel and bottom of the foot, common in runners due to repetitive stress.
- Achilles Tendinitis: Inflammation of the Achilles tendon, leading to pain in the back of the ankle, which can occur from overuse or sudden increase in running activity.
- Stress Fractures: Small cracks in the bone, often in the shin or foot, resulting from repetitive stress and overuse, common in runners who increase their mileage too quickly.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although less common, DVT can cause leg pain and swelling, and it's crucial to consider this diagnosis, especially if there's a history of clotting disorders or recent travel.
- Compartment Syndrome: A condition where pressure within the muscle compartments increases, leading to pain, swelling, and potentially serious complications if not addressed promptly.
- Osteonecrosis: Death of bone tissue due to lack of blood supply, which can be caused by trauma or repetitive stress, and might present with pain in the affected area.
Rare Diagnoses
- Stress Reaction or Insufficiency Fracture: Similar to stress fractures but occur in bones with underlying conditions, such as osteoporosis.
- Neoplastic Conditions: Tumors, either benign or malignant, which can cause pain in the bones or soft tissues of the lower extremities.
- Infectious Processes: Osteomyelitis (bone infection) or septic arthritis, which are less common but can present with pain, swelling, and redness in the affected area.
- Nerve Entrapment Syndromes: Conditions like tarsal tunnel syndrome, where the posterior tibial nerve is compressed, leading to pain and numbness in the foot.