What is the most likely diagnosis for pain located posterolaterally in the calf, particularly pain exacerbated by ankle dorsiflexion and inversion?

The symptoms described point most directly to sural nerve neuropathy as the most likely diagnosis. Pain located posterolaterally in the calf that worsens with ankle dorsiflexion and inversion suggests irritation or entrapment of the sural nerve, which runs in that region.

The sural nerve provides sensory innervation to the posterior and lateral aspects of the leg and the lateral side of the foot. When the nerve becomes irritated or compressed, it can elicit pain in the distribution described, particularly with movements that may stretch or otherwise put stress on the area where the nerve runs. Ankle dorsiflexion and inversion can create tension in the structures surrounding the nerve, leading to increased pain.

In contrast, conditions such as an Achilles tendon rupture would typically present with pain and inability to perform a heel raise, rather than isolated pain in the calf that is associated with specific movements like dorsiflexion and inversion. Plantar fasciitis primarily causes heel pain and discomfort with weight-bearing activities, not specifically in the calf or exacerbated by the movements described. Peripheral artery disease would present with claudication, typically experienced as cramping or pain with exertion that resolves with rest, and does not localize specifically to the area mentioned with