Published on
​Symptoms and Signs – Differential Diagnosis of Plantar Heel Pain 
SKIN
• Keratoses
• Verruca
• Ulcer
• Fissure
FAT
• Atrophy
• Panniculitis
DENSE CONNECTIVE TISSUE
• Inflammatory fasciitis
• Fibromatosis
• Enthesopathy
• Bursitis
BONE (CALCANEUS)
• Stress fracture
• Paget’s disease
• Benign bone cyst/tumor
• Malignant bone tumor
• Metabolic bone disease (osteopenia)
NERVE
• Tarsal tunnel
• Plantar nerve entrapment
• S1 nerve root radiculopathy
• Painful peripheral neuropathy
INFECTION
• Dermatomycoses
• Acute osteomyelitis
• Plantar abscess
MISCELLANEOUS
• Foreign body
• Nonunion calcaneus fracture
• Psychogenic
• Idiopathic
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Acute Headache 
• Bone, soft tissue: referred pain from scalp, eyes, ears, sinuses, nose, teeth, pharynx, cervical spine, temporomandibular joint
• Decreased ICP: after ventriculoperitoneal shunt, lumbar puncture, cerebrospinal fluid leak from basilar skull fracture
• First migraine
• Increased intracranial pressure (ICP): trauma, hemorrhage, tumor, hydrocephalus, pseudotumor cerebri, abscess, arachnoid cyst, cerebral edema
• Infection: systemic infection, encephalitis, sinusitis, others
• Meningeal inflammation: meningitis, leukemia, subarachnoid or subdural hemorrhage
• Vascular: vasculitis, arteriovenous malformation, hypertension, cerebrovascular accident
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Headache and Facial Pain
VASCULAR HEADACHES
• Migraine
• Migraine with headaches and inconspicuous neurologic features
Migraine without aura (“common migraine”)
• Migraine with headaches and conspicuous neurologic features With transient neurologic symptoms: migraine with typical aura (“classic migraine”), sensory, basilar, and
hemiplegic migraine With prolonged or permanent neurologic features
(“complicated migraine”): ophthalmoplegic migraine, migrainous infarction
• Migraine without headaches but with conspicuous neurologic features (“migraine equivalents”)
Abdominal migraine
Benign paroxysmal vertigo of childhood
• Migraine aura without headache (“isolated auras,” transient
migrainous accompaniments)
• Cluster headaches
• Episodic cluster headache (“cyclic cluster headaches”)
• Chronic cluster headaches
• Chronic paroxysmal hemicrania
• Other vascular headaches
• Headaches of reactive vasodilation (fever, drug induced,
postictal, hypoglycemia, hypoxia, hypercapnia,
hyperthyroidism)
• Headaches associated with arterial hypertension Chronic severe hypertension (diastolic >120 mm Hg)
Paroxysmal severe hypertension (pheochromocytoma, some coital headaches)
• Headaches caused by cranial arteritis
Giant cell arteritis (“temporal arteritis”)
Other vasculitides
HEADACHES ASSOCIATED WITH DEMONSTRABLE
MUSCLE SPASM
• Headache caused by posturally induced or paralesional muscle spasm
• Headaches of sustained or impaired posture (e.g., prolonged close work, driving)
• Headaches associated with cervical spondylosis and other diseases of cervical spine
• Myofascial pain dysfunction syndrome (headache or facial pain associated with disorders of teeth, jaws, and related structures, or “temporomandibular joint [TMJ] syndrome”)
• Headaches caused by psychophysiologic muscle contraction (“muscle contraction headaches,” or tension type of headache associated with disorder of pericranial muscles)
HEADACHES AND FACIAL PAIN WITHOUT DEMONSTRABLE PHYSICAL SUBSTRATE
• Headaches of uncertain etiology: “tension headaches” (tension type of headache unassociated with disorder of pericranial muscles)
• Some forms of post-traumatic headache
• Psychogenic headaches (e.g., hypochondriacal, conversional, delusional, malingering)
• Facial pain of uncertain etiology (“atypical facial pain”)
COMBINED TENSION-MIGRAINE HEADACHES
• Episodic migraine superimposed on chronic tension headaches
• Chronic daily headaches: associated with analgesic or ergotamine overuse (“rebound headaches”)
• Not associated with drug overuse
HEADACHES AND HEAD PAINS CAUSED BY DISEASES OF EYES, EARS, NOSE, SINUSES, TEETH, OR SKULL HEADACHES CAUSED BY MENINGEAL INFLAMMATION
• Subarachnoid hemorrhage
• Meningitis and meningoencephalitis
• Others (e.g., meningeal carcinomatosis)
HEADACHES ASSOCIATED WITH ALTERED INTRACRANIAL PRESSURE (“TRACTION HEADACHES”)
Increased Intracranial Pressure
• Intracranial mass lesions (e.g., neoplasm, hematoma, abscess)
• Hydrocephalus
• Benign intracranial hypertension
• Venous sinus thrombosis
Decreased Intracranial Pressure
• Post–lumbar puncture headaches
• Spontaneous hypoliquorrheic headaches
HEADACHES AND HEAD PAINS CAUSED BY CRANIAL NEURALGIAS
Presumed Irritation of Superficial Nerves
• Occipital neuralgia
• Supraorbital neuralgia
Presumed Irritation of Intracranial Nerves
• Trigeminal neuralgia (“tic douloureux”)
• Glossopharyngeal neuralgia
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of  Granuloma Annulare
• Tinea corporis
• Sarcoidosis
• Rheumatoid nodules
• Papular granuloma annulare can simulate insect bites, secondary syphilis, xanthoma.
• Necrobiosis lipoidica diabeticorum
• Lichen planus
• Late secondary or tertiary syphilis
• Arcuate and annular plaques of mycosis fungoides
• Annular elastolytic giant cell granuloma
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Granulomatous Dermatitides
• Sarcoidosis
• Rheumatoid nodules
• Necrobiosis lipoidica diabeticorum
• Granuloma annulare
• Foreign body granuloma
• Cutaneous Crohn’s disease
• Annular elastolytic giant cell granuloma (actinic granuloma)
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Granulomatous Disorders
INFECTIONS
Fungi
• Histoplasma
• Coccidioides
• Blastomyces
• Sporothrix
• Aspergillus
• Cryptococcus
Protozoa
• Toxoplasma
• Leishmania
Metazoa
• Toxocara
• Schistosoma
Spirochetes
• Treponema pallidum
• Treponema pertenue
• Treponema carateum
Mycobacteria
• Mycobacterium tuberculosis
• Mycobacterium leprae
• Mycobacterium kansasii
• Mycobacterium marinum
• Mycobacterium avium
• Bacille Calmette-Guérin (BCG) vaccine
Bacteria
• Brucella
• Yersinia
Other Infections
Cat-scratch disease
• Lymphogranuloma

NEOPLASIA
• Carcinoma
• Reticulosis
• Pinealoma
• Dysgerminoma
• Seminoma
• Reticulum cell sarcoma
• Malignant nasal granuloma

CHEMICALS
• Beryllium
• Zirconium
• Silica
• Starch
• Immunologic aberrations
• Sarcoidosis
• Crohn’s disease
• Primary biliary cirrhosis
• Wegener’s granulomatosis
• Giant cell arteritis
• Peyronie’s disease
• Hypogammaglobulinemia
• Systemic lupus erythematosus (SLE)
• Lymphomatoid granulomatosis
• Histiocytosis X
• Hepatic granulomatous disease
• Immune complex disease
• Rosenthal-Melkersson syndrome
• Churg-Strauss allergic granulomatosis
LEUKOCYTE OXIDASE DEFECT
• Chronic granulomatous disease of childhood

EXTRINSIC ALLERGIC ALVEOLITIS
• Farmer’s lung
• Bird fancier’s lung
• Mushroom worker’s lung
• Suberosis (cork dust)
• Bagassosis
• Maple bark stripper’s lung
• Paprika splitter’s lung
• Coffee bean dust
• Spatlese lung

OTHER DISORDERS
• Whipple’s disease
• Pyrexia of unknown origin
• Radiotherapy
• Cancer chemotherapy
• Panniculitis
• Chalazion
• Sebaceous cyst
• Dermoid
• Sea urchin spine injury
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Granulomatous Liver Disease
• Allergic granulomatosis
• Drugs (e.g., allopurinol, hydralazine, sulfonamides, penicillins)
• Erythema nodosum
• Hodgkin’s disease
• Infections (fungal, viral, parasitic)
• Inflammatory bowel disease (IBD)
• Lymphoma
• Primary biliary cirrhosis
• Sarcoidosis
• Toxins (copper sulfate, beryllium)
• Vasculitis
• Wegener’s granulomatosis
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Graves’ Disease
• Anxiety disorder
• Premenopausal state
• Thyroiditis
• Other causes of hyperthyroidism (e.g., toxic multinodular goiter,
toxic adenoma)
• Other: metastatic neoplasm, diabetes mellitus (DM),
pheochromocytoma
Picture