Differential Diagnosis for Child with Pain in Both Heels
Single Most Likely Diagnosis
- Sever's Disease (Calcaneal Apophysitis): This is the most common cause of heel pain in children, typically affecting those between the ages of 8 and 14. It is characterized by inflammation of the growth plate in the heel, often due to overuse or repetitive stress from activities such as running or jumping.
Other Likely Diagnoses
- Plantar Fasciitis: Inflammation of the plantar fascia, a band of tissue that runs along the bottom of the foot, can cause pain in the heel. While more common in adults, it can also occur in children, especially those who are overweight or engage in activities that involve a lot of running or jumping.
- Achilles Tendinitis: Inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, can cause pain in the back of the heel. This condition is more common in active children who participate in sports.
- Overuse Injuries: Repetitive stress or overuse from sports or physical activities can lead to various injuries, including stress fractures, that cause heel pain.
Do Not Miss Diagnoses
- Tumor or Cancer: Although rare, tumors such as osteosarcoma or Ewing's sarcoma can cause heel pain in children. Early detection is crucial for effective treatment.
- Infection (Osteomyelitis or Septic Arthritis): Bacterial infections can cause pain, swelling, and redness in the heel. Prompt diagnosis and treatment are necessary to prevent serious complications.
- Fracture: Stress fractures or other types of fractures in the heel can cause significant pain and require proper management to heal correctly.
Rare Diagnoses
- Kohler Disease: A rare condition characterized by avascular necrosis of the navicular bone, which can cause foot pain, including heel pain, in children.
- Freiberg's Disease: A rare condition that affects the metatarsal bones in the foot, causing pain and stiffness, but can sometimes refer pain to the heel area.
- Rheumatologic Conditions: Certain rheumatologic diseases, such as juvenile idiopathic arthritis, can cause heel pain among other symptoms, though this is less common.