What are the differential diagnoses for heel trauma?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
DS

Dainyal Siddiqui, MD

Internal Medicine

MJ

Manuel Jimenez, MD

Cardiology

FP

Franz Pierre-Louis, MD

Infectious Disease

Article Review Status
Submitted
Under Review
Approved

Last updated: May 17, 2025 • View editorial policy

Heel Trauma Differential Diagnosis

The following differential diagnosis is organized into categories to help guide the thought process:

  • Single most likely diagnosis

    • Plantar fasciitis: This is the most common cause of heel pain and is often associated with trauma or overuse. The plantar fascia is a band of tissue that supports the arch of the foot, and inflammation or strain of this tissue can cause significant pain.

  • Other Likely diagnoses

    • Achilles tendonitis: Inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, can cause pain and stiffness in the heel area. Trauma or overuse can lead to this condition.
    • Heel bruise (contusion): A direct blow to the heel can cause a bruise, leading to pain, swelling, and discoloration.
    • Calcaneal stress fracture: A stress fracture of the calcaneus (heel bone) can occur due to repetitive stress or trauma, causing pain and discomfort.

  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)

    • Calcaneal fracture: A fracture of the calcaneus can be a serious injury, especially if it involves the joint surface. Missing this diagnosis could lead to long-term disability and chronic pain.
    • Infection (osteomyelitis or septic arthritis): Infection of the bone or joint can occur after a traumatic injury, especially if the skin is broken. Prompt diagnosis and treatment are crucial to prevent serious complications.
    • Compartment syndrome: This is a rare but potentially devastating condition that occurs when pressure builds up within the muscle compartments of the foot or ankle, leading to nerve and muscle damage.

  • Rare diagnoses

    • Tarsal tunnel syndrome: Compression of the posterior tibial nerve as it passes through the tarsal tunnel can cause pain, numbness, and tingling in the heel and foot.
    • Bursitis: Inflammation of the bursae (fluid-filled sacs) that cushion the heel bone and surrounding tissues can cause pain and swelling.
    • Heel pad atrophy: Thinning of the fat pad under the heel can cause pain and discomfort, especially when walking or standing.

Related Questions

What is the diagnosis for a 32-year-old woman at 11 weeks gestation (gestational age) with vaginal bleeding, a dilated cervix, and an empty uterus on ultrasound, indicating no evidence of intrauterine pregnancy (intrauterine pregnancy)?
What is the primary cause of urinary tract infections (UTIs) in pediatric patients, particularly those under 2 years of age?
What labs are indicated for a patient experiencing heaviness in the legs, also known as (lower extremity) paresthesia?
What are the treatment options for acute gouty arthritis?
What is the time frame for initiating colchicine treatment after the onset of a gout (gouty arthritis) attack?
What is the treatment for Leptospirosis?

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.

Ask a new Question. Chat with the Guidelines