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Wheeless' Textbook of Orthopaedics

Seever's Diease / Calcaneal Apophysitis



- Discussion:
    - classically described as causing heel pain in older children, just prior to fusion of the calcaneal apophysis (between ages 12-15 yrs);
    - diff dx: seronegative arthritis
    - often associated with tight heel cord;
    - it has been argued in the past that the radiographic fragmentation of the apophysis correlated w/ the patient's symptoms;
    - as is shown below, however, fragmentation of the apophysis is a normal finding;

- Normal Radiographs:




Prevention and management of calcaneal apophysitis in children: An overuse syndrome.
    LJ Micheli and MO Ireland.  J. Pediatric Orthopaedics.  Vol 7. 1987. p 34-38.

Sever's injury: A stress fracture of the immature calcaneal metaphysis. J Ped Orthop 2004;24:488-492.









Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Sunday, February 1, 2009 5:19 pm