2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose), sediment if necessary. Fasting glucose … Heel Pain: Test and Diagnosis
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Radiographs of the affected region – to demonstrate arthritis (joint inflammation), osteomyelitis (bone marrow inflammation), march fracture, etc. Skeletal scintigraphy (nuclear medicine procedure that can represent functional changes in … Heel Pain: Diagnostic Tests
The following symptoms and complaints may occur along with heel pain: Leading symptoms Acute versus chronic foot pain Sharp versus dull pain Radiating pain Load-dependent pain Associated symptoms Movement restriction Neurological symptoms such as paresthesias (misfeeling). Redness Overheating Warning signs (red flags) Anamnestic information: Peripheral arterial occlusive disease (pAVD) + nocturnal footpad pain → think: … Heel Pain: Symptoms, Complaints, Signs
To the extent that foot pain or a heel pain can be attributed to a specific disease, see drug therapy, surgery, and “other therapy” under that disease. General measures Cool and spare Avoid predominant activities while standing! Nicotine restriction (refrain from tobacco use). Aim for normal weight! Determination of BMI (Body Mass Index, body mass … Heel Pain: Therapy
The anamnesis (medical history) represents an important component in the diagnosis of foot pain. Family history What is the general health of your family members? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). Where exactly is the pain localized? What is the character of the pain? Sharp? Dull? How … Heel Pain: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Foot deformities, e.g., flat foot (pes planus), high arch (pes cavus, pes excavatus). Endocrine, nutritional and metabolic diseases (E00-E90). Burning-feet syndrome (synonyms: burning-feet syndrome, Gopalan syndrome, Grierson-Gopalan syndrome); symptomatology: Painful burning sensation in the feet (in nocturnal attacks), often associated with paresthesias (numbness); etiology (cause) is unknown, hypovitaminosis … Heel Pain: Or something else? Differential Diagnosis
Heel pain (ICD-10-GM M79.62: Pain in extremities: ankle and foot [tarsal, metatarsal, toes, ankle, other joints of the foot]) is pain occurring in the heel. The pain may occur not only with exertion, but also at rest. Heel pain can be a symptom of many diseases (see under differential diagnoses). Heel pain is often caused … Heel Pain: What to do when your heel hurts
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing) of the foot and lower extremities, pelvis, and back while standing and walking [ingrown toenail?, leg length discrepancy?, deformities?, foot deformities?, warts?, swelling?, scoliosis?, color changes?] … Heel Pain: Examination