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This Saturday I saw a patient who complains of pain in the Right heel area for 3 weeks.She is unsure of history of trauma.She reports moderate to severe pain especially with gait.Upon examination,I noticed a fair amount of edema in the right retrocalcaneal region with pain on dorsiflexion.Side to side palpation was somewhat painful.Gait was WNL.I sent her for Xrays and started on Feldene.Any ideas what this can be?

 

I have more questions than answers

Before I post you a long list of questions, perhaps looking at this thread would save some time

http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=22144

Robin

 

Patient denies history of trauma.Her pain is steady but worse with walking.She has had for 3 weeks and has not self treated.She is diabetic(Type 2).
Upon physical exam,she presents with pain and edema in the Right retrocalcaneal area.ROM is normal for dorsiflexion but there is pain.Her gait is slightly antalgic with limp favoring R side.She wears sneakers.Muscle strength,tone and bulk are normal.
My diagnosis(tentatively) is bursitis.
I sent her for plain film radiographs and feldene qd for 2 weeks.I will follow up then to evaluate pain and function.

 

I realize my posts contradicted each other.First I said her gait was WNL then I said limp.She did indeed present with a limp.