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Evidence based diagnosis of heel pain

Discussion in 'Biomechanics, Sports and Foot orthoses' started by ernepod, Dec 28, 2013.

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  1. ernepod

    ernepod Member


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    Hi there and happy Christmas to all , I'm in the process of reading around' diagnosis 'of heel pain with a view to developing a research question for a systematic review.
    I have found many adult patients come into clinic having attended their GP or self diagnosed 'plantar fasciitis' and quite rightly in some cases. However it is the Ddx that interests me e.g tts . I have looked at validity of windlass .:bash:

    Thanks in advance
    Eileen
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    An "evidence based" approach to the diagnosis of heel pain is going to have to focus on the validity, specificity and sensitivity of various clinical tests to accurately make the diagnosis --- there is really no data on that to do a systematic review!
     
  3. evh59

    evh59 Member

    Hi Eileen,

    There is pretty comprehensive pathway for plantar fasciitis and DDX of heel pain on the NHS Map of Medicine. I have used it as a basis for much of my pathways for heel pain.

    Best Wishes and Good Luck

    Edd Henstridge
     
  4. kjsrug

    kjsrug Member

    Hi
    Today I have a patient who was diagnosed by a consutant with calcaneal bone oedema following an MRI This was associated with plantar fascia thickening, plantar fibromas and heelspurs. She has rested in a cast boot for 12 weeks but still has residual deep pain in her right heel. I was asked by her employers for advice. Evidence concerning calaneal bone oedema and its association with plantar fasciitus would be of interest.
    Karen Stone
     
  5. toomoon

    toomoon Well-Known Member

    Karen, given the chronic nature of the condition, if it has been present for 6 months or longer, and has been resistant to other forms of conservative treatment, I think there is now at least adequate evidence to consider a course of ESWT.
    best
    Simon
     
  6. ernepod

    ernepod Member

    Hi Kjsrug-yes I would certainly be interested in the progress of this patient and literature available.Has the patient any recollection of injury? do they have any of the other risk factors assoc with plantar fasciitis?
    I think my initial point was even if a patient appears on clinical exam,history and ?ultrasound to have PlF -they may also have another condition associated with heel pain.
     
  7. kjsrug

    kjsrug Member

    This patient is a postal worker, is not obese and her day consists mainly of mixed driving and walking. There is no history of injury but I think a high impact aerobics class may be a contributory factor
     
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