Differential Diagnosis for Plantar Fasciitis
When considering the diagnosis of plantar fasciitis, it's essential to rule out other potential causes of heel pain. Here's a categorized differential diagnosis:
- Single Most Likely Diagnosis
- Plantar fasciitis: This is the most common cause of heel pain, characterized by inflammation of the plantar fascia, a band of tissue that runs along the bottom of the foot. The pain is typically worse in the morning and after periods of rest.
- Other Likely Diagnoses
- 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.
- Calcaneal stress fracture: A small crack in the heel bone can cause pain, especially with weight-bearing activities.
- Fat pad atrophy: Thinning of the fat pad under the heel can lead to pain and discomfort.
- Peripheral neuropathy: Nerve damage can cause burning, numbness, or tingling sensations in the heel.
- Do Not Miss Diagnoses
- Infection (e.g., osteomyelitis or septic arthritis): Although less common, infections in the foot or ankle can be severe and require prompt treatment.
- Tumor (e.g., osteoid osteoma): A benign or malignant tumor in the foot or ankle can cause persistent pain.
- Deep vein thrombosis (DVT): A blood clot in the deep veins of the leg can cause pain, swelling, and warmth in the affected area.
- Rare Diagnoses
- Paget's disease: A rare bone disorder that can cause heel pain and deformity.
- Rheumatoid arthritis: An autoimmune disorder that can cause inflammation and pain in the joints, including the foot and ankle.
- Sarcoidosis: A condition that can cause inflammation and pain in various parts of the body, including the foot and ankle.
Each of these diagnoses has distinct characteristics and requires a thorough evaluation to determine the underlying cause of the patient's symptoms.