The heel in systemic disease

Heel pain is most commonly the result of mechanical abnormality in foot structure or function. Systemic disease, however, may also affect the heel, resulting in pain, deformity, or both of the rearfoot. This article discusses and reviews notable systemic conditions, exclusive of the seronegative spondyloarthropathies, which may produce subjective or objective heel findings. Specific conditions discussed are rheumatoid arthritis, crystal deposition arthropathies, osteoporosis, diffuse idiopathic skeletal hyperostosis, diabetes mellitus, hypertrophic osteoarthropathy, Paget's disease, hyperlipidemia, sarcoidosis, sickle cell anemia, and acromegaly and their effects on the heel.