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].
- Inspection (viewing).
- 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)
- Possible causes:
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.