| Is there pain over the plantar insertion of the plantar fascia into the medial calcaneus? |
- Is this worse with first steps in the morning and tender to palpation? Consider plantar fasciitis.
- Is there night pain and diffuse tenderness when calcaneus is squeezed? Consider calcaneal stress fracture.
- Is tenderness greatest directly over the os calcis and not made worse by extension of the great toe? Consider split fat pad or contusion/minor fracture of os calcis.
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| Is there pain at the posterior calcaneus with a bony irregularity? |
- Is there swelling and pain when the distal Achilles tendon is squeezed? Consider enthesopathy.
- Is there tenderness and/or swelling directly over the bony irregularity? Consider painful Haglund deformity with possible swelling.
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| Is there a rigid flat foot and some bony irregularity of the rear foot? |
- Is rear foot motion restricted? Consider tarsal coalition.
- Is there a discreetly palpable bony irregularity? Consider an accessory ossicle.
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| Is there pain at the talar dome or lateral talar area? |
- Is pain made worse by dorsiflexion or plantarflexion of the ankle? Consider anterior impingement syndrome from tibial or talar spurring.
- Is pain at the lateral talus, and has the patient had a severe or recurrent ankle sprains? Consider osteochondral injury of talus.
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| Is there pain behind or pain and swelling just anterior to the lateral malleolus? |
- Does resisted foot eversion make pain worse? Consider fibularis (peroneal) tendinopathy.
- Is swelling greater anterior to lateral malleolus, and is rear foot pronated? Consider sinus tarsi syndrome.
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| Is there pain in the rear foot just superior to the calcaneus? |
- Does pain increase with single or repeated plantar flexion? Consider os trigone or posterior impingement from talar spurring.
- Is pain made worse by squeezing area deep to the Achilles tendon? Consider retrocalcaneal bursitis.
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| Is there pain along the plantar surface of the foot but no tenderness? |
- Is there a positive Tinel's sign at the tarsal tunnel, or marked pronation? Consider tarsal tunnel syndrome.
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| Are there painless, flesh colored papules along the fat pad and calcaneus? |
- Is there any reason for increased pressure on heel strike? Consider piezogenic papules.
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