FRACS Orthopaedic Exams
A 58 year old physically active woman in excellent health presents complaining of pain around the medial aspect of the ankle and hindfoot. Symptoms have become persistent, slowly worsening and are significantly limiting her activities. There is no past history of any injury or joint problem. Clinical examination demonstrates swelling and tenderness about the medial hind-foot.
1. Give your top six differential diagnoses, with clinical features for each.
Three months later, the symptoms have progressed and the medial longitudinal arch shows some flattening.
2. What is the natural history of the most likely diagnosis?