Two-week history of refusal to walk due to severe bilateral heel pain, which increased with activity.
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Sclerosis and fragmentation of the calcaneal apophysis are seen on both sides.
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.
- 1. Kose O, Celiktas M, Yigit S et-al. Can we make a diagnosis with radiographic examination alone in calcaneal apophysitis (Sever's disease)?. J Pediatr Orthop B. 2010;19 (5): 396-8. doi:10.1097/BPB.0b013e32833a5fa7 - Pubmed citation