Differential Diagnosis for Pain in the Transverse Arch of the Foot

• Single most likely diagnosis
  • Plantar fasciitis: This condition is the most common cause of pain in the bottom of the heel and the transverse arch of the foot. It occurs due to inflammation of the plantar fascia, a band of tissue that supports the arch of the foot.
• Other Likely diagnoses
  • Overuse or strain of the foot muscles: Repetitive activities or sudden increases in physical activity can lead to strain or overuse of the muscles in the foot, causing pain in the transverse arch.
  • Flat feet or low arch: Individuals with flat feet or low arches may experience pain in the transverse arch due to the abnormal distribution of weight and stress on the foot.
  • Morton's neuroma: This condition involves the thickening of tissue around a nerve in the foot, leading to pain, usually between the third and fourth toes, but can also radiate to the transverse arch.
• Do Not Miss diagnoses
  • Stress fracture: A stress fracture in one of the bones of the foot can cause pain in the transverse arch. This is a critical diagnosis not to miss, as it requires proper rest and treatment to heal.
  • Infection (e.g., osteomyelitis, septic arthritis): Infections in the foot can cause severe pain and require immediate medical attention to prevent serious complications.
  • Deep vein thrombosis (DVT): Although less common, DVT can cause pain in the foot and leg, and it is crucial to diagnose and treat promptly to prevent life-threatening conditions like pulmonary embolism.
• Rare diagnoses
  • Tarsal tunnel syndrome: This condition involves compression of the posterior tibial nerve as it travels through the tarsal tunnel on the inner side of the ankle, leading to pain and numbness in the foot, including the transverse arch.
  • Arthritis (e.g., rheumatoid arthritis, psoriatic arthritis): Certain types of arthritis can cause pain and inflammation in the joints of the foot, including those in the transverse arch.
  • Peripheral neuropathy: Damage to the peripheral nerves can cause pain, numbness, and tingling in the feet, including the transverse arch, often associated with conditions like diabetes.