Differential Diagnosis for Posterior Heel Pain and Antalgic Limp in Young Athletes
- Single most likely diagnosis:
- Sever's Disease (Calcaneal Apophysitis): This condition is the most common cause of heel pain in young athletes, typically affecting children between 8-14 years old. It is characterized by inflammation of the calcaneal apophysis, which is a growth plate at the back of the heel. The pain is usually exacerbated by activity and relieved by rest.
- Other Likely diagnoses:
- Achilles Tendinitis: Inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, can cause posterior heel pain and an antalgic limp, especially in young athletes who participate in sports that involve running or jumping.
- Plantar Fasciitis: Although more common in adults, plantar fasciitis can also occur in young athletes, causing pain in the heel and bottom of the foot.
- Heel Stress Fracture: Overuse or repetitive stress on the heel bone can lead to a stress fracture, which may cause pain and an antalgic limp in young athletes.
- Do Not Miss diagnoses:
- Tumor (e.g., Osteoid Osteoma): Although rare, a tumor in the heel or ankle can cause persistent pain and should not be missed, as it may require urgent medical attention.
- Infection (e.g., Osteomyelitis or Septic Arthritis): Infection in the bone or joint can cause severe pain, redness, and swelling, and requires prompt medical attention to prevent serious complications.
- Rare diagnoses:
- Retrocalcaneal Bursitis: Inflammation of the bursa that separates the Achilles tendon from the heel bone can cause posterior heel pain and swelling.
- Haglund's Deformity: A bony growth on the back of the heel bone can cause pain and inflammation, especially if it irritates the Achilles tendon.