An 8-Year-Old Boy Is Brought to the Office for Evaluation

An 8-year-old boy is brought to the office for evaluation of heel pain.  The patient has had increasing pain in the back of his heels for the past 2 months during basketball season.  The pain was tolerable until a recent 3-day basketball tournament, which exacerbated his heel pain.  He has no pain in other joints and does not recall a specific injury.  The patient has no chronic medical conditions and takes no daily medications.  Temperature is 36.7 C (98 F) .  He is at the 98th percentile for height and the 55th percentile for weight.  The patient has a normal gait but is unable to stand directly on his heels without pain.  Bilateral heels have mild swelling, and the bases of both are tender to palpation.  Dorsiflexion of the ankle elicits pain.  The Achilles tendon is nontender.  Which of the following is the most likely cause of this patient's heel pain?

A) Achilles tendinopathy
B) Calcaneal apophysitis
C) Juvenile idiopathic arthritis
D) Plantar fasciitis
E) Tarsal tunnel syndrome

Correct Answer:

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