Investigations
- none usually necessary as diagnosis is clinical
- x-ray unhelpful other than to exclude other causes. Presence of spur is not diagnostic
- plasma viscosity, C-reactive protein (CRP) and HLA-B27 may be useful if bilateral, and other enthesopathy or arthropathy present
- nerve conduction tests if clinical suspicion of tarsal tunnel syndrome, but not enough confidence to inject
- ultrasound, magnetic resonance imaging (MRI) and bone scan via secondary care, if not responding after 3 months' treatment. (This is a fairly arbitrary figure from the USA)
Reference:
- ARC (February 2004). Hands On - practical advice on the management of rheumatic disease, 2.
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