Seronegative spondyloarthritides (Reiter's syndrome, ankylosing spondylitis, or psoriatic arthritis) was diagnosed in 24 of 30 patients with severe heel pain. Most of the patients were carriers of the antigen HLA B27. Talalgia was frequently the first symptom of disease. Heel surgery is contra-indicated during the inflammation phase, since it may cause local aggravation and risk of ankylosis of the talocalcaneal articulation. Other causes of heel pain include tendon chondrocalcinosis, local tuberculous infection, and nodular tendinitis caused by a partial rupture of the tendon. On the other hand, severe talagia was rarely found in rheumatoid arthritis, and no case was related to the presence of tophi or xanthomas of the Achilles tendon.