Welcome to the American Family Physician podcast for the January 15th, 2018 issue.

I'm Steve.

I'm Shari. I'm Steve. I'm Shari.

I'm Sue.

I'm Sarah.

We are residents and faculty from the University of Arizona College of Medicine, Phoenix,

Family Medicine Residency.

This time on the podcast, we're going to talk about heal pain, a hypertension guideline,

H. Pylori, preeclampsia screening,

colorectal cancer screening, and we'll bring back our favorite tweets.

The opinions expressed in the podcast are our own and do not represent the opinions

of the American Academy of Family Physicians, the Editor of American Family Physician,

or Banner Health. Do not use this podcast for medical advice. Instead, see your own family doctor for medical care.

First up, we have heal pain diagnosis and management from Dr. 2 from Roanoke, Virginia.

One approach to working through the many causes of heal pain is by location. Starting posteriorly,

the age of the patient can clue us in. Seaver disease, or calcaneal apophysitis, is the most common cause of heal pain in children. Look for an active 8 to 12 year old presenting during a growth

spurt or at the beginning of a sports season. Pain is elicited with palpation around the Achilles

insertion, medial calcaneal compression, and passive dorsiflection. For adults, if the pain is over the

Achilles or at its insertion and with passive dorsiflection, think Achilles tendonopathy. Excessive

loading, like in running, or fluoroquinolone use in older patients can cause this. If the pain

is surrounding the Achilles with a prominent posterior calcaneus,

hagglin deformity, plus or minus retrocalcanial brisitis could be at play. Restrictive

...