24 yr old woman walking up experiences pain in heel which decreases on walking down. X-ray shows bone spur. Diagnosis -
ACHILLES TENDINITIS Athletes, joggers and hikers often develop pain and swelling around the tendo Achillis, due to local irritation of the tendon sheath or the paratenon. PATHOLOGY :The condition usually affects the 'watershed' area about 4 cm above the inseion of the tendon, an area where the blood supply to the tendon is poorer than elsewhere. The tendon sheath or the flimsy tissue around it may become inflamed. In a minority of cases the changes appear at the tendon inseion, or there may be inflammation of the retrocalcaneal bursa just above the calcaneum and deep to the tendon; anatomical deformity of the posterior pa of the calcaneum may contribute to the pathogenesis. CLINICAL FEATURES : The condition may come on gradually, or rapidly following a change in spoing activity (or a change of spos footwear). Less commonly there is a history of direct trauma to the Achilles tendon Reference - Apley&;s system of ohopaedics-9th edn pg no 614.
Plantar fasciitis
Calcaneal exostosis
Osteomyelitis of calcaneum
Achillis tendinitis
Bony dysplasia and soft tissue affection