What is the diagnosis?
This is likely mechanical foot pain as a result of his foot posture and hypermobility.
However in view of the symptoms of morning stiffness and family history, inflammatory joint disease should be considered - he does not have evidence of arthritis or enthesitis (see pREMS - foot and ankle).
His tenderness is consistent with Sever's disease (osteochondritis of the heels).
He does not have growing pains as he has daytime symptoms.
If there are clinical concerns then referral to paediatric rheumatology is warranted.
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