4.3 of 43 Ratings
A 34-year-old female has an insidious onset of heel pain when first getting out of bed and at the end of the day after prolonged standing. She works as a waitress and recently had bariatric surgery with a current BMI of 35. She has a gastrocnemius contracture noted on Silverskiold testing. AP and oblique radiographs are shown in Figure A and lateral radiograph is shown in Figure B. What is the most likely diagnosis?
Navicular stress fracture
First branch of the lateral plantar nerve (Baxter's) entrapment
Anterior tarsal tunnel syndrome
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A 44-year-old recreational runner began training for a half marathon 6 weeks ago. Over the last week he has developed heel pain that is worse in the morning upon awakening and when he arises from his desk at the end of the workday. Physical exam is notable for tenderness with direct palpation of the anteromedial heel. Which of the following is the best initial management?
Stretching of the achilles tendon and plantar fascia along with a prefabricated shoe insert
Immobilization in a short leg cast
Steroid injection of the plantar fascia
Custom made orthotic with arch support
Surgical release of the medial third of the plantar fascia origin