Presentation
Basketball player with a six-week history of pain in the posterior aspect of the both heels with limp and intense pain when jumping. The pain worsened with training and prevented return to sports activity. The pain began spontaneously without any history of trauma.
Patient Data
X -ray feet
Increased density and fragments on of calcaneal apophysis on both sides.
Case Discussion
Sever’s disease or calcaneal apophysitis is an inflammatory condition of the growth plate of the heel bone and is due to repetetive microtrauma by traction on the adhesion site of the Achilles tendon to the calcaneal tuberosity. The X-ray shows an increase in the density with fragmentation of the calcaneal epiphysis (radiolucent line of the epiphysis). These finding are not specific and could be present in patients without symptoms. The x-rays may not be needed for reaching at diagnosis but x-ray findings do help to exclude other causes of heel pain.
The X-ray shows increased density of the calcaneal apophyses, and radiolucent lines through the apophyses indicating fragmentation.
Radiographer: TSRM Fabio Imola
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