J Korean Orthop Assoc.
2001 Aug;36(4):333-338.
Differential Diagnosis of Heel Pain in Seronegative Spondyloarthropathy from the Heel Pain Syndrome
- Affiliations
-
- 1Department of Orthopaedic Surgery, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea.
- 2Department of Nuclear Medicine, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea.
Abstract
- PURPOSE
We attempted to differentiate the heel pain in seronegative spondyloarthropathy from that in the posterior heel pain syndrome.
MATERIALS AND METHODS
Forty one patients who complained of heel pain were included in this study. The evaluation consisted of history taking, physical examination, roentgenogram, bone scan, and serological tests including ESR, CRP, rheumatoid factor, and HLA-B27. The patients were classified into two groups. Group A consisted of seronegative spondyloarthropathy patients and group B consisted of plantar fasciitis, Achilles tendinitis, and retrocalcaneal bursitis patients.
RESULTS
There were 14 patients in group A, and 27 patients in group B. The characteristic clinical features were the following in group A compared with those in group B. The age of patients was younger and males predominated. Also patients complained of a combined metatarsalgia or other joint pain. On the physical examination, tenderness existed on the calcaneal body rather than the bony attachment site of Achilles tendon or plantar fascia. Serologic tests revealed an elevated ESR, and a positive HLA-B27. A bone scan showed diffuse uptake in the calcaneal body and the metatarsophalangeal joint area, and an increased SIS ratio.
CONCLUSION
Seronegative spondyloarthropathy should be differentiated in a patient who complains of heel pain.
