Heel Spur: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; furthermore:
    • Inspection (viewing).
      • Gait pattern (fluid, limping) [stabbing pain when walking (especially in the morning after getting up); especially plantar pain just below the calcaneus; later, pain independent of weight-bearing]
      • Body or joint posture (upright, bent, gentle posture).
      • Malpositions (deformities, contractures, shortenings).
      • Muscle atrophies (side comparison!, if necessary circumference measurements).
    • Palpation (palpation) of the foot [With targeted examination, a pressure pain at the base of the plantar aponeurosis (plantar tendon plate), ie in the area of the calcaneus (heel bone) can be triggered].
  • Further orthopedic examinations wg:
    • Possible causes:
      • Malpositions of the foot such as the bent-countersunk foot.
      • Insertion tendopathy of the plantar fascia (soft tissue components of the connective tissue of the sole of the foot) at the calcaneus (heel bone) – irritation at the junction between tendons and bones (= insertion), usually caused by overloading
    • Differential diagnoses:
      • Bursitis (inflammation of the bursa).
      • Chronic polyarthritis
      • Coalitio talonavicularis – malformation of the navicular and calcaneal bones.
      • Fatigue fracture (fatigue fracture)
      • Gout (hyperuricemia)
      • Calcaneal cyst (cyst in the heel bone area).
      • Bekhterev’s disease – chronic inflammatory disease of the spine, which can lead to joint stiffness (ankylosis) of the affected joints.
      • Paget’s disease (osteitis deformans) – bone disease associated with greatly increased bone remodeling.
      • Osteomyelitis (bone marrow inflammation)
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.