What is the cause of pain with knee and foot flexion, specifically pain on dorsiflexion (movement towards the shin) and plantarflexion (movement towards the sole)?

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Differential Diagnosis for Pain with Knee and Foot Flexion

Single Most Likely Diagnosis

  • Plantar fasciitis: This condition is characterized by inflammation of the plantar fascia, leading to pain in the heel and bottom of the foot, which can be exacerbated by flexion of the foot and knee due to the increased tension on the plantar fascia.

Other Likely Diagnoses

  • Achilles tendinitis: Inflammation of the Achilles tendon can cause pain in the back of the ankle, which may worsen with flexion of the foot and knee due to increased stress on the tendon.
  • Shin splints: Medial tibial stress syndrome, commonly known as shin splints, can cause pain in the lower leg, which may be exacerbated by activities that involve flexion of the foot and knee, such as running or jumping.
  • Knee ligament sprains or strains: Injuries to the ligaments surrounding the knee can cause pain, especially with movements that involve flexion, such as bending or squatting.

Do Not Miss Diagnoses

  • Deep vein thrombosis (DVT): Although less common, DVT can cause pain in the leg, which may worsen with flexion due to increased pressure on the affected vein. Missing this diagnosis can be life-threatening due to the risk of pulmonary embolism.
  • Compartment syndrome: This is a serious condition characterized by increased pressure within a muscle compartment, leading to pain, especially with flexion or extension of the affected limb. It requires immediate medical attention to prevent permanent damage.
  • Osteonecrosis: Also known as avascular necrosis, this condition involves the death of bone tissue due to a lack of blood supply. It can cause pain in the affected bone, which may be exacerbated by movement, including flexion of the knee and foot.

Rare Diagnoses

  • Tarsal tunnel syndrome: This condition involves compression of the posterior tibial nerve as it travels through the tarsal tunnel on the inner side of the ankle, leading to pain, numbness, and tingling in the foot, which may worsen with flexion.
  • Flexor hallucis longus tendinitis: Inflammation of the tendon that flexes the big toe can cause pain in the foot and ankle, especially with activities that involve flexion of the foot and knee.

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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