Differential Diagnosis for Posterior Lateral Heel Pain
Single Most Likely Diagnosis
- Peroneal Tendinopathy: Pain in the posterior lateral heel near the lateral malleolus is commonly associated with peroneal tendinopathy, which involves inflammation of the peroneal tendons that run behind the lateral malleolus. This condition is often seen in individuals who participate in activities that involve repetitive ankle motion.
Other Likely Diagnoses
- Peroneal Tenosynovitis: This condition involves inflammation of the tendon sheath surrounding the peroneal tendons and can cause pain and swelling in the area behind the lateral malleolus.
- Lateral Ankle Impingement: This condition occurs when there is compression of the soft tissues between the lateral malleolus and the calcaneus, leading to pain in the posterior lateral heel.
- Subtalar Joint Dysfunction: Dysfunction of the subtalar joint, which is located below the ankle joint, can cause pain in the posterior lateral heel due to altered biomechanics and stress on the surrounding tissues.
Do Not Miss Diagnoses
- Rupture of the Peroneal Tendons: Although less common, a rupture of the peroneal tendons can occur and would require prompt medical attention to prevent further complications and improve outcomes.
- Osteochondral Lesion of the Talus: An osteochondral lesion (a defect in the cartilage and bone) of the talus can cause deep ankle pain and may be associated with pain in the posterior lateral heel, especially if the lesion is located in the lateral aspect of the talus.
- Infection or Abscess: Infection in the soft tissues or bone near the lateral malleolus can cause severe pain and swelling and requires immediate medical attention.
Rare Diagnoses
- Tarsal Coalition: An abnormal connection between two or more of the tarsal bones in the foot can lead to altered biomechanics and pain in various locations, including the posterior lateral heel.
- Haglund's Deformity: A bony enlargement at the back of the heel bone can cause pain and inflammation of the surrounding soft tissues, including the area near the lateral malleolus.
- Neoplastic Conditions: Although rare, tumors (benign or malignant) can occur in the bones or soft tissues near the lateral malleolus and cause pain in the posterior lateral heel.