Differential Diagnosis for Posterior Heel Pain in Young Athletes
- Single most likely diagnosis
- Calcaneal apophysitis (Sever's disease): This condition is the most common cause of posterior heel pain in young athletes, particularly during periods of rapid growth. It is characterized by inflammation of the calcaneal apophysis and is often associated with an antalgic limp, especially with activity.
- Other Likely diagnoses
- Achilles tendinitis: Inflammation of the Achilles tendon can cause posterior heel pain and an antalgic limp, especially in young athletes who participate in sports that involve running or jumping.
- Retrocalcaneal bursitis: Inflammation of the retrocalcaneal bursa can cause pain and swelling in the posterior heel, leading to an antalgic limp.
- Plantar fasciitis: Although more common in adults, plantar fasciitis can also occur in young athletes, causing heel pain and an antalgic limp.
- Do Not Miss diagnoses
- Osteomyelitis: A bone infection that can cause severe pain, swelling, and redness in the affected area, including the posterior heel. Although rare, it is a serious condition that requires prompt medical attention.
- Tumor (e.g., osteoid osteoma): A rare but potentially serious condition that can cause persistent pain and an antalgic limp.
- Rare diagnoses
- Haglund's deformity: A rare condition characterized by a bony prominence on the posterior aspect of the calcaneus, which can cause pain and inflammation.
- Insertional Achilles tendinosis: A rare condition characterized by degeneration of the Achilles tendon at its insertion on the calcaneus, which can cause pain and stiffness in the posterior heel.