Differential Diagnosis for Heel Pain in a 74-year-old
Single most likely diagnosis
- Plantar fasciitis: This is the most common cause of heel pain in adults, especially in older individuals. It is characterized by inflammation of the plantar fascia, leading to pain and stiffness in the heel, particularly after periods of rest or in the morning.
Other Likely diagnoses
- Achilles tendinitis: Inflammation of the Achilles tendon can cause heel pain, especially in older adults who may have reduced flexibility and increased wear and tear on the tendon.
- Heel spur: A bony growth on the underside of the heel bone, which can cause pain when walking or standing.
- Bursitis: Inflammation of the bursae (fluid-filled sacs) near the heel can cause pain and swelling.
- Osteoarthritis: Wear and tear on the joints in the foot, including the heel, can cause pain and stiffness.
Do Not Miss diagnoses
- Calcaneal fracture: A fracture of the heel bone, which can be caused by a fall or other trauma. This is a serious condition that requires prompt medical attention.
- Infection (e.g. osteomyelitis or septic arthritis): Infections in the bone or joint can cause severe pain and swelling, and require urgent medical attention.
- Tumor (e.g. bone cancer): Although rare, tumors in the heel can cause pain and swelling, and require prompt medical evaluation.
Rare diagnoses
- Rheumatoid arthritis: An autoimmune disorder that can cause inflammation and pain in the joints, including the heel.
- Gout: A type of arthritis that can cause sudden, severe pain and swelling in the joints, including the heel.
- Peripheral neuropathy: Nerve damage that can cause pain, numbness, or tingling in the heel and foot.
- Tarsal tunnel syndrome: Compression of the nerves in the foot, which can cause pain, numbness, or tingling in the heel and foot.