Differential Diagnosis for Posterior Heel Pain with Bump

• Single most likely diagnosis
  • Haglund's deformity: This condition is characterized by a bony enlargement on the posterior aspect of the heel, which can cause pain and a noticeable bump. It is often associated with Achilles tendonitis and is more common in individuals who wear tight or poorly fitting shoes.
• Other Likely diagnoses
  • Achilles tendonitis: Inflammation of the Achilles tendon can cause pain in the posterior heel region and may be associated with a bump or swelling.
  • Retrocalcaneal bursitis: Inflammation of the bursa that separates the Achilles tendon from the calcaneus can cause pain and swelling in the posterior heel.
  • Pump bump (retrocalcaneal exostosis): A bony growth on the posterior heel that can cause pain and a bump, often due to repetitive pressure from poorly fitting shoes.
• Do Not Miss diagnoses
  • Tumor (e.g., osteochondroma, giant cell tumor): Although rare, a tumor in the posterior heel region can cause pain and a noticeable bump. It is crucial to consider this possibility to ensure timely diagnosis and treatment.
  • Infection (e.g., osteomyelitis, septic bursitis): Infections in the heel region can cause pain, swelling, and a bump, and require prompt medical attention to prevent serious complications.
• Rare diagnoses
  • Rheumatologic conditions (e.g., rheumatoid arthritis, ankylosing spondylitis): Certain rheumatologic conditions can cause heel pain and swelling, although this is less common.
  • Stress fracture: A stress fracture in the calcaneus can cause posterior heel pain, although this is relatively rare compared to other causes.