Differential Diagnosis Flashcards
Medial ankle pain
Common: tibialis posterior tendinopathy
Flexor hallucis longus tendinopathy
Less common: Medial calanceal nerve entrapment Calcaneal stress fracture Tarsal tunnel syndrome Talar stress fracture Medial malleolar stress fracture Posterior impingement syndrome Referred pain - Lumbar
Not to be missed: Navicular stress fracture Complications of acute ankle injury CRPS type 1 Septic arthritis Gout
Lateral ankle pain
Common: Peroneal tendinopathy
Sinus tarsi syndrome
Less common: Impingement syndrome (anterior or posterior)
Recurrent dislocation of peroneal tendons
Stress fracture of the talus
Referred pain (lumbar, peroneal nerve, superior TibFib joint)
Not to be missed: Stress fracture of the distal fibula Cuboid syndrome CRPS Septic arthritis Gout
Acute ankle injury
Common: Lateral ligament sprain
less common: Osteochondral lesion of the talus Medial ligament sprain AITFL injury Fractures Ankle dislocation Tendon rupture/dislocations
Not to be missed: CRPS
Greenstick fracture (children)
Sprained syndesmosis
Tarsal coalition
Achilles region
Common: Midportion achilles tendinopathy (incl. tendinosis, paratendonitis, partial tears)
Posterior impingement syndrome
Insertional achilles tendinopathy (incl. retrocalcaneal bursitis, haglund’s disease, severs disease)
Less common: Achilles bursitis
Accessory soleus muscle
Referred pain
Not to be missed: Achilles tendon rupture
Inflammatory arthropathy
Calf pain
Common: muscle strains
muscle contusions
DOMS
Less common: posterior compartment syndrome Referred pain Vascular entrapment Nerve entrapment Stress fracture
Not to be missed: DVT
Acute knee pain
Common: Medial meniscal tear MCL sprain ACL sprain (rupture) Lateral meniscal tear Articular cartilage injury PCL sprain Patellar dislocation
Less common: Patellar tendon rupture Quadriceps tendon rupture Acute patellofemoral contusion LCL sprain Bursal haematoma/bursitis Acute fat pad impingement Avulsion of biceps femoris tendon Dislocation of superior tibiofibular joint
Not to be missed: Fracture of the tibial plateua Avulsion fracture of tibial spine Osteochondritis dissecans CRPS Quadriceps rupture
Anterior knee pain
Common: Patellofemoral pain
Patellar tendinopathy
Less common: Fat pad impingement Osgood-schletters lesion Quadriceps tendinopathy Infrapatellar bursitis Sinding-larsen-johansson lesion stress fracture patellar synovial plica
Not to be missed: Referred pain from hip (SUFE, perthes)
osteochondritis dessicans
tumor
Medial, lateral, posterior knee pain
Common: ITB friction syndrome
Lateral meniscus
less common: Knee OA Biceps femoris tendinopathy Superior tibiofibular joint sprain Synovitis of the knee joint Referred pain
Not to be missed: Common peroneal injury
SUFE
Perthes
Anterior thigh pain
Common: Quadriceps muscle strain/contusion
Myositis Ossificans
Less common: Referred pain
Stress fracture femur
Sartorius muscle strain
Gracilis strain
Avulsion of the apophysis of rectus femoris
Nerve entrapment - lateral or femoral cutaneous N
Not to be missed: SUFE Perthes Tumor eg: osteosarcoma of the femur Acute compartment syndrome
Posterior thigh pain
Common: Hamstring muscle strain/contusion Referred pain (lumbar) Neural structures
less common: Referred pain (SIJ)
Hamstring tendinopathy
Bursitis (semimembranosus, ischiogluteal)
Chronic compartment syndrome
Apophysitis/avulsion fracture of the ischial tuberosity
Nerve entrapment (sciatic, posterior cutaneous N)
Adductor magnus strain
Myositis ossificans
Not to be missed:
Tumor
Vascular
Groin pain
Common:
Adductor related: tendinopathy/enthesopathy
Iliopsoas related: Tendinopathy, bursitis
Abdominal wall related: Posterior inguinal wall weakness, tear of external oblique aponeurosis, rectus abdominis tendiopathy
Pubic bone related: pubic bone stress
Hip joint: Chondral lesion, labral tear
Less common:
Stress fracture - neck of femur, pubic ramus, Acetabulum
Nerve entrapment - Obturator, ilioinguinal, genitofemoral
Referred pain
Apophysitis - ASIS, AIIS
Not to be missed: SUFE, Perthes Intra-abdominal abnormality Spondyloarthropathies AVN Tumor
Anterior hip pain
Common: Synovitis Labral tear Chondropathy OA FAI
Less common: Os Acetabuale Ligamentum teres tear Stress fracture Hip joint instability Traction apophysitis
Not to be missed: AVN Perthes/SUFE Tumor Inflammatory disorders (RA, AS) Aortoiliac arterial insufficiency Septic arthritis
Lateral hip pain
Common:
Greater trochanter pain syndrome
Gluteus medius tears and tendinopathy
Trochanteric bursitis
less common:
Referred pain from lumbar spine
Not to be missed:
Fracture of the neck of femur
Nerve root compression
Tumor
Buttock pain
Common: Referred pain (Lx, SIJ) Hamstring origin tendinopathy Ischiogluteal bursitis Myofascial apin
Less common: Quadratus femoris injuries Piriformis conditions Fibrous adhesions around sciatic nerve Prolapsed intervertebral disc Chronic compartment syndrome of the posterior thigh Stress fracture of the sacrum Proximal HS origin avulsion Apophysitis/avulsion fracture Gluteus medius tendinopathy
Not to be missed:
Spondyloarthropathies (AS, reactive arthritis, psoriatic arthritis)
malignancy
Low back pain
Common:
Somatic injury (IV disc, Facet joint)
SIJ
Paravertebral and gluteal muscle trigger points
Less common: IV disc prolapse - acute nerve root compression Spondylolisthesis Lumbar hypermobility Spondylosis Spinal canal stenosis Vertebral crush fracture Hip joint pathology Fibromyalgia Rheumatological causes Gynecological causes Gastrointestinal causes Genitourniary causes
Not to be missed: Malignancy Multile myeloma Severe osteoporosis Cauda equina Myelopathy
