小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 足跟疼痛（刺痛或刀割样疼痛）
- 休息后疼痛缓解
- 静止后运动障碍
其他诊断因素
- 赤足行走疼痛加重
- 使用非甾体抗炎药可缓解疼痛
- 无足跟部急性损伤的病史
- 自限性疼痛
- 单侧足跟疼痛
- 背伸-外翻试验阳性
- Windlass试验阳性
- Tinel征阴性
危险因素
- 肥胖
- 马蹄足
- 扁平足
- 弓形足
- 年龄超过40岁
- 长时间站立史
- 跑步者
诊断性检查
首要检查
- 足部X线片
需考虑的检查
- 骨扫描（锝）
- 核磁共振成像 (MRI)
- HLA-B27
- 类风湿因子
新兴检查
- 超声
治疗流程
所有患者
撰稿人
作者
Martha Anderson, DPM, FACFAS
Podiatric Foot and Ankle Surgeon
Private Practice
Foot and Ankle Wellness Center
Podiatric Foot and Ankle Surgeon
Department of Surgery
Grady Memorial Hospital
Delaware
OH
利益声明
MA declares that she has no competing interests.
鸣谢
Dr Martha Anderson would like to gratefully acknowledge Dr Georgeanne Botek, the previous contributor to this topic. GB declares that she has no competing interests.
同行评议者
Mark A. Hardy, DPM, FACFAS
Director
Foot and Ankle Trauma Service
Kaiser Permanente
Cleveland
OH
利益声明
MAH declares that he has no competing interests.
Molly Judge, DPM, FACFAS
Board Certified in Reconstructive Rear foot and Ankle Surgery
Department of Surgery
St. Vincent Charity Hospital
Cleveland
OH
利益声明
MJ declares that she has no competing interests.
Patrick J. McKee, DPM
Program Director
Podiatric Residency
Cleveland Clinic
Cleveland
OH
利益声明
PJM declares that he has no competing interests.
鉴别诊断
- 跖筋膜断裂
- 跟骨下方黏液囊炎
- 跟骨挫伤
更多 鉴别诊断指南
- ACR 适用性标准：慢性足部疼痛
- 体外冲击波治疗顽固性跖筋膜炎
更多 指南患者教育信息
Heel pain (plantar fasciitis)
Obesity - diet and exercise
更多 患者教育信息
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