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Differential Diagnosis for Pain at the Plantar Surface Anterior to Calcaneus

Single Most Likely Diagnosis

  • Plantar Fasciitis: This condition is characterized by inflammation of the plantar fascia, a band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes. Pain is typically worse with activities that involve toe walking or standing on the toes, which matches the patient's symptoms.

Other Likely Diagnoses

  • Fat Pad Atrophy: This condition involves the loss of the fatty tissue under the heel or ball of the foot, leading to pain and discomfort, especially when standing or walking on toes.
  • Plantar Fibroma: A benign growth on the plantar fascia that can cause pain, especially if it is large enough to press on surrounding tissues or nerves.
  • Morton's Neuroma: Although typically found between the toes, a neuroma (nerve thickening) can sometimes cause pain that radiates to the midfoot, especially if it involves nerves that supply this area.

Do Not Miss Diagnoses

  • Tarsal Tunnel Syndrome: A condition that involves compression of the posterior tibial nerve as it travels through the tarsal tunnel on the inner side of the ankle. It can cause pain, numbness, and tingling in the foot, including the plantar surface and midfoot.
  • Deep Vein Thrombosis (DVT): Although less common in the foot, DVT can cause pain and swelling, and it is crucial to rule out this condition due to its potential for serious complications, such as pulmonary embolism.
  • Osteomyelitis or Septic Arthritis: Infections of the bone or joint, respectively, which can cause severe pain and have significant consequences if not promptly treated.

Rare Diagnoses

  • Lipoma of the Foot: A rare, benign tumor composed of fat tissue that can cause pain if it presses on surrounding structures.
  • Gout or Pseudogout: Although more commonly associated with the big toe, these conditions can cause sudden, severe pain in other parts of the foot, including the midfoot.
  • Erythromelalgia: A disorder that causes burning pain, heat, and redness in the hands and feet, which could potentially be confused with other causes of foot pain.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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