Differential Diagnosis for Pain over Transverse Arch of Foot

• Single most likely diagnosis
  • Plantar fasciitis: This condition is the most common cause of pain in the foot, especially in the heel and arch area. The pain is usually worse in the morning and improves with activity. The transverse arch of the foot is a common area for plantar fasciitis to cause pain due to the fascia's attachment and support role in this region.
• Other Likely diagnoses
  • Overuse or strain of the foot muscles: Activities that involve repetitive stress on the foot, such as running or dancing, can lead to strain of the muscles supporting the transverse arch, causing pain.
  • Flat feet or fallen arches: Individuals with flat feet or fallen arches may experience pain in the transverse arch due to the altered biomechanics and increased stress on the foot.
  • Morton's neuroma: Although more commonly associated with pain between the toes, a neuroma in the third interspace can radiate pain to the transverse arch area.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Deep vein thrombosis (DVT): While less common, DVT can present with pain in the foot, including the arch area, and is a medical emergency due to the risk of pulmonary embolism.
  • Osteomyelitis or septic arthritis: Infection of the bone or joint in the foot can cause severe pain and requires prompt antibiotic treatment to prevent serious complications.
  • Tumor: Although rare, a tumor in the foot can cause pain in the transverse arch and is crucial to diagnose early for effective treatment.
• Rare diagnoses
  • Tarsal tunnel syndrome: Similar to carpal tunnel syndrome in the wrist, tarsal tunnel syndrome involves compression of the posterior tibial nerve as it travels through the tarsal tunnel on the inner side of the ankle, which can cause pain in the arch of the foot.
  • Stress fracture: A small crack in one of the bones in the foot can cause pain in the arch area, especially with activity.
  • Peripheral artery disease: Reduced blood flow to the foot can cause pain, especially with activity, and is more common in individuals with risk factors such as smoking or diabetes.