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Sever disease

Case contributed by Bahman Rasuli
Diagnosis possible

Presentation

Two-week history of refusal to walk due to severe bilateral heel pain, which increased with activity.

Patient Data

Age: 10 years
Gender: Male
x-ray

Sclerosis and fragmentation of the calcaneal apophysis are seen on both sides.

Case Discussion

Sever disease is a type of the non-articular osteochondrosis of the calcaneal apophysis. Foot radiograph findings in Sever disease have low sensitivity and specificity because those with Sever disease may not have it, thus radiological identification of calcaneal apophysitis without the absence of clinical information is not reliable. The main differential is normal fragmentation of the calcaneal apophysis. 

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