Question
A 32 year old athlete attends the clinic with a complaint of posterior heel pain. Which of the following could be the differential diagnosis?
| A. |
Achilles tendinopathy
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| B. |
Tendon rupture
|
| C. |
Retrocalcaneal bursitis
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| D. |
All of the above
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Show Answer
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Correct Answer � D
Explanation
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|
The most important d/d for posterior heel pain are Achilles tendinopathy (midsubstance or insertional) and tendon rupture (partial or complete). Achilles disorders will localize pain to the Achilles tendon, typically along its course from the insertion on the heel to its transition into the conjoined tendon of the gastrocnemius and soleus.
However, differential diagnoses include retrocalcaneal bursitis or enthesitis, plantaris muscle injury, posterior ankle impingement, and sural nerve impingement or entrapment.
Ref: Alvarez-Nenegyei J, Canoso JJ. Heel pain: diagnosis and treatment, step by step. Cleveland Clin J Med2004;73:465-71; Achilles tendon disorders ; BMJ 2013;346:f1262.
