Differential Diagnosis for Left Heel Pain near Achilles with a Bump on the Back of Heel

• Single Most Likely Diagnosis
  • Achilles Tendinosis or Tendinitis: This condition is characterized by pain, swelling, and sometimes a bump on the back of the heel due to inflammation or degeneration of the Achilles tendon. The location of the pain and the presence of a bump are classic signs.
• Other Likely Diagnoses
  • Haglund's Deformity: A bony enlargement on the back of the heel that can cause pain and a noticeable bump, often due to irritation from shoes or chronic inflammation.
  • Bursitis (Retrocalcaneal or Achilles Bursitis): Inflammation of the bursae near the Achilles tendon, which can cause pain and swelling in the area, sometimes with a palpable bump.
  • Insertional Achilles Tendinitis: Specifically refers to inflammation at the insertion point of the Achilles tendon on the calcaneus, which can cause pain and a bump.
• Do Not Miss Diagnoses
  • Tumor (e.g., Soft Tissue Sarcoma): Although rare, a tumor could present as a bump on the back of the heel with associated pain. Missing this diagnosis could have severe consequences.
  • Infection (e.g., Osteomyelitis or Abscess): An infection in the bone or soft tissue could cause pain, swelling, and a bump, and requires prompt treatment to avoid serious complications.
• Rare Diagnoses
  • Rheumatologic Conditions (e.g., Rheumatoid Arthritis, Psoriatic Arthritis): These conditions can cause heel pain and swelling but are less common causes of a bump on the back of the heel.
  • Stress Fracture of the Calcaneus: A fracture due to repetitive stress could cause heel pain but might not typically present with a noticeable bump unless there's an associated soft tissue reaction.