Differential Diagnosis for Left Heel/Ankle Pain
- Single most likely diagnosis
- Calcaneal stress fracture: The patient's history of stomping his foot on a hard surface and the initial pain in the calcaneus area, which later moved to the ankle talus area, suggests a stress fracture. The lack of bruising or swelling and the ability to walk on the foot with 5/10 pain also support this diagnosis.
- Other Likely diagnoses
- Ankle sprain: Although the patient did not report any twisting or rolling of the ankle, the pain in the talus area could be indicative of a mild ankle sprain.
- Contusion of the heel or ankle: The patient's mechanism of injury (stomping his foot) could have caused a contusion, which may not be visible as bruising or swelling.
- Talus fracture: A fracture of the talus bone could also be a possibility, given the patient's symptoms and mechanism of injury.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteonecrosis of the talus: Although rare, osteonecrosis of the talus could be a potential complication of a talus fracture or contusion, and missing this diagnosis could lead to serious consequences.
- Infection (e.g., osteomyelitis or septic arthritis): Although unlikely, an infection could be a potential complication of a puncture wound or other trauma to the foot or ankle.
- Rare diagnoses
- Tarsal tunnel syndrome: Compression of the posterior tibial nerve could cause pain in the heel and ankle area, but this is a less likely diagnosis given the patient's mechanism of injury.
- Plantar fasciitis: Inflammation of the plantar fascia could cause heel pain, but this is typically a chronic condition and less likely to be related to a single traumatic event.