Differential Diagnosis
- Single most likely diagnosis
- Plantar fasciitis: The presence of a small plantar calcaneal spur is a common finding in patients with plantar fasciitis, which is a condition characterized by inflammation of the plantar fascia. The normal alignment and mineralization of the bones, as well as the lack of signs of fracture or arthritic changes, support this diagnosis.
- Other Likely diagnoses
- Heel spur syndrome: This condition is often associated with plantar fasciitis and can cause pain and discomfort in the heel area. The presence of a plantar calcaneal spur is a key finding in this diagnosis.
- Overuse injury: The presence of a small plantar calcaneal spur could be indicative of an overuse injury, such as a stress reaction or a bone bruise, which can occur in athletes or individuals who engage in repetitive activities.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteoid osteoma: Although rare, an osteoid osteoma can present with a small calcaneal spur and should be considered in the differential diagnosis, especially if the patient is experiencing night pain or pain that is relieved by NSAIDs.
- Infection: Although there are no signs of infection on the imaging, it is essential to consider this possibility, especially if the patient has a history of recent trauma, fever, or other systemic symptoms.
- Rare diagnoses
- Haglund's deformity: This is a rare condition characterized by a bony prominence on the posterior aspect of the calcaneus, which can cause pain and discomfort. Although the imaging does not show a prominent bony deformity, it is essential to consider this diagnosis in patients with heel pain.
- Seronegative spondyloarthropathy: This group of conditions, including ankylosing spondylitis and psoriatic arthritis, can cause heel pain and spurs. Although rare, these conditions should be considered in patients with a history of inflammatory back pain or other systemic symptoms.