10 year old boy with ankle joint pain. Finding? Dx?
alcaneal apophysitis (Sever’s disease) is the most common cause of heel pain in young athletes. It is a painful inflammation of the heel’s calcaneal apophysis growth plate, believed to be caused by repetitive microtrauma from the pull of the Achilles tendon on the apophysis. Patients with calcaneal apophysitis may have activity-related pain in the back part of the heel. Sixty percent of patients report pain in both heels.
This condition is usually treated conservatively with calf stretching and arch supports. Some athletes’ calves are so tight that heel lifts may be indicated. The young athlete should be able to return to normal activities as the pain decreases. Calcaneal apophysitis may last for months. Increasing pain, despite trying the listed treatment recommendations, warrants a return visit to the physician.
