James Bond experiences heel pain and suspects fat pad involvement; which test would best identify fat pad squeeze?

James Bond experiences heel pain and suspects fat pad involvement; which test would best identify fat pad squeeze?

• A. Plantar fasciitis test
• B. Noble
• C. Fat pad squeeze test
• D. Valgus overload

Answer: (C)

Directly loading the fat pad to see if it reproduces the patient’s pain is the approach here. When fat pad pathology is suspected, you want a maneuver that targets the heel’s padding itself. The fat pad squeeze test does exactly that by applying gentle compression to the heel’s fat pad; if this produces focal tenderness or pain in the pad area, it supports involvement of the fat pad. Other tests target different structures: a plantar fascia-focused test stresses the plantar fascia and would elicit pain there rather than from the fat pad; Noble test is for iliotibial band friction at the knee; valgus overload stresses knee ligaments. So a focused squeeze of the heel pad is the most specific way to identify fat pad issues. To perform, place one hand on the plantar heel and gently compress the heel pad with the other hand; reproduction of pain in the fat pad region indicates a positive result.

Directly loading the fat pad to see if it reproduces the patient’s pain is the approach here. When fat pad pathology is suspected, you want a maneuver that targets the heel’s padding itself. The fat pad squeeze test does exactly that by applying gentle compression to the heel’s fat pad; if this produces focal tenderness or pain in the pad area, it supports involvement of the fat pad.

Other tests target different structures: a plantar fascia-focused test stresses the plantar fascia and would elicit pain there rather than from the fat pad; Noble test is for iliotibial band friction at the knee; valgus overload stresses knee ligaments. So a focused squeeze of the heel pad is the most specific way to identify fat pad issues. To perform, place one hand on the plantar heel and gently compress the heel pad with the other hand; reproduction of pain in the fat pad region indicates a positive result.