Foot and ankle history and clinical examination: A guide to everyday practice

Table 1 Correlations between the anatomical site of the pain and the possible underlying causes[6]

Location of pain	Common possible pathology
Anterior ankle pain	Degenerative disease	Impingement
		Ankle joint capsule injury ex. Sport injury with maximum ankle joint plantar flexion
Medial pain below the medial malleolus	Sinus tarsi syndrome Subtalar degenerative changes Tarsal coalition of mid facet	Spring ligament or deltoid ligament pathology Tibialis posterior pathology or medial impingement
Postero-medial pain	Tibialis posterior tendonitis	Flexor hallucis longus Tarsal tunnel syndrome
Posterior pain	Achilles tendinopathy Posterior impingement	Os trigonum pathology
Postero-lateral pain	Peroneal tendon
Lateral pain	Stress fracture of distal fibula ATFL injury Lateral impingement	Sinus tarsi syndrome Subtalar pathology Calcaneal fracture malunion
Heel pain	Plantar fasciitis Calcaneal stress fracture Entrapment of first branch of lateral plantar nerve	Fat pad atrophy/contusion Tarsal tunnel syndrome Foreign body reaction Plantar fascia rupture
Mid foot pain	Degenerative disease Post traumatic arthritis	Tarsal bones stress fracture Ligament injury ex Lisfranc injury Insertional tendinopathy of peroneal brevis
Forefoot pain	Metatarsalgia Morton neuropathy Stress fracture Freiberg disease	Metatarsophalangeal joint synovitis Nail pathology
Forefoot pain - big toe	Hallux valgus/rigidus Inflamed bunion	Sesamoiditis Sesamoid fracture
Forefoot pain - 2nd, 3rd and 4th toe	Claw toe Hammer toe	Mallet toe
Forefoot pain - little toe	Inflamed bunionette

ATFL: Anterior inferior tibiofibular ligament.