American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary condition resulting in pain and tenderness near the medial plantar heel surface?

1. Achilles tendonitis

2. Plantar fasciitis

3. Heel spur syndrome

4. Foot fracture

The correct answer is: Plantar fasciitis

Plantar fasciitis is characterized by inflammation and irritation of the plantar fascia, which is a thick band of tissue that runs across the bottom of the foot. The primary symptom is pain and tenderness localized near the medial plantar heel surface, particularly noticeable with the first steps taken in the morning or after prolonged periods of sitting. This condition is often caused by repetitive strain, excessive stretching, or improper footwear, leading to micro-tears in the fascia. The pain typically worsens after activity and can be associated with changes in gait or foot mechanics. Understanding the nature of plantar fasciitis helps healthcare providers recommend effective treatment options, including stretching exercises, physical therapy, orthotics, and anti-inflammatory medications. While conditions like Achilles tendonitis and heel spur syndrome could also involve heel pain, they present with different symptoms and locations of tenderness. Foot fractures generally present with more acute, sharp pain and often feature swelling or bruising, which helps differentiate them from the more gradual onset associated with plantar fasciitis.