HEEL PAIN

Ask the Following Questions:

1. Are there abnormalities on inspection of the heel? Inspection of the heel may disclose an ulcer, foreign body, cellulitis, plantar wart, and other disorders.
2. Is the patient a child? Children often have Sever's disease (osteochondritis of the heel).
3. Is there tenderness or deformity of the Achilles tendon? Tenderness or deformity of the Achilles tendon should suggest Achilles tendinitis, rupture, or bursitis.
4. Are there abnormalities on x-ray examination? An x-ray may disclose a calcaneal fracture, osteomyelitis, a tumor, or calcaneal spur. If the x-ray is negative, plantar fasciitis is the most likely diagnosis, but one should also consider gout.

DIAGNOSTIC WORKUP

In addition to a plain x-ray of the foot, a CBC, sedimentation rate, chemistry panel, and arthritis panel should be done. A bone scan may disclose an occult fracture. Response to a trigger point injection should be evaluated. If the diagnosis is still in doubt, referral to an orthopedic surgeon or podiatrist should be made before ordering expensive diagnostic tests such as a CT scan or MRI.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Heel pain

Read excerpts from these other book chapters related to Heel pain:

Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Heel pain

• Back to symptom: Heel pain: Introduction (review 15 causes)
• Next Book Extract About Heel pain: FOOT, HEEL, AND TOE PAIN (Differential Diagnosis in Primary Care)
• All Book Extracts: All Online Book Extracts for Heel pain

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

 » Next page: FOOT, HEEL, AND TOE PAIN (Differential Diagnosis in Primary Care)

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