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Differential diagnosis to Plantar Fascittis

Discussion in 'General Issues and Discussion Forum' started by Fazzaroo14, Sep 6, 2013.

  1. Fazzaroo14

    Fazzaroo14 Welcome New Poster

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    Hi all, wanting to pick your brains. New patient in today with suspected PF of the right foot?? Has previously been prescribed insoles and has changed footwear but has had no improvement and notes a significant increase in pain levels over the last two weeks. Causing pain to thigh level and the right foot is significantly warmer in temperature when compared to the left. Patient is a shop worker with no history of trauma, no medical history, no vascular insufficiency, and good ROM all joint. Pain on palpating of the MLA. Have asked GP for RHA factor test and white blood cell count. Anyone any suggestions as to an alternative diagnosis? It's just not sitting well with me. Many thanks.

  2. Admin2

    Admin2 Administrator Staff Member

  3. Tim Foran

    Tim Foran Active Member

    Medial Calcaneal nerve entrapment
    Baxters nerve entrapment
    Check PTTD if heat

    There are many more
  4. Fazz:

    You may want to read this thread, Presenting Patients for Clinical Advice, if you want to get more useful replies to your clinical question.

    You may also consider first spelling out your acronyms before you use them since not every podiatrist in every country uses the same acronyms or even knows what your acronyms mean. Remember, Podiatry Arena is an international podiatric academic website.

    Finally, your real name at the end of your posting would also ensure that more of us would take the time to try to answer your questions for you.
  5. drdebrule

    drdebrule Active Member

  6. MissB

    MissB Active Member


    Plantar fasciitis/fasciosis is indeed a common heel pathology, but it's not the only one. Admin2 has provided a number of differential diagnoses for you to consider.

    Aside from range of motion and palpating the medial longitudinal arch, what other tests did you do? I hope your assessment was more comprehensive than that? The results of your assessment tests should point you to a diagnosis.

    Have you checked the orthoses? Have you tested the sub talar joint axis? It may be that the centre of pressure is on the axis, which may account for the increase in pain. Alternatively, the orthoses may place more pressure at the site of the trapped nerve ( if Baxters) leading to an increase in pain
  7. clm

    clm Welcome New Poster

    Interesting presentation with pain proximal to thigh. Good to rule out infection and RA factors. I have had patients with saphenous vein and nerve issues present with medial distal lower extremity and proximal (just area of adductor insertions) symptoms.

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