Heel Spur 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 a heel spur. The pain is typically worse in the morning and improves with activity.
- Other Likely Diagnoses
- Achilles tendinitis: Inflammation of the Achilles tendon can cause heel pain, especially with activity.
- Bursitis: Inflammation of the bursae around the heel can cause pain and swelling.
- Heel fat pad atrophy: Thinning of the fat pad under the heel can cause pain and discomfort.
- Stress fracture: A small crack in the bone can cause heel pain, especially with weight-bearing activities.
- Do Not Miss Diagnoses
- Osteomyelitis: Bone infection can cause severe heel pain and is a medical emergency.
- Tumor: A bone tumor, such as an osteoid osteoma, can cause heel pain and should not be missed.
- Neuroma: A nerve tumor, such as a Morton's neuroma, can cause heel pain and numbness.
- Infection: A skin or soft tissue infection, such as cellulitis or abscess, can cause heel pain and swelling.
- Rare Diagnoses
- Haglund's deformity: A bony growth on the back of the heel can cause pain and swelling.
- Retrocalcaneal bursitis: Inflammation of the bursae behind the Achilles tendon can cause heel pain.
- Spondyloarthritis: A type of arthritis that can cause heel pain and inflammation.
- Gout: A type of arthritis that can cause sudden, severe heel pain and swelling.
Each diagnosis has a brief justification to help guide the thought process. It's essential to consider the patient's symptoms, medical history, and physical examination to narrow down the differential diagnosis.