Calcified nodules on the heel: A complication of neonatal intensive care

Abstract

WE HAVE OBSERVED children with calcified, nodular heei lesions in Our newborn high-risk follow-up clinic.' O'Doherty ~ has also reported this finding, but not specifically in high-risk infants. This report describes what is known about tlie natural history, the physical examination, and the microscopic findings of these lesions to alert caretakers to their correct identification. PATIENT P OPULATION Our newborn high:risk follow-up clinic enrolls 120 infants yearly, one-half of whom are less than 1,500 gm at birth and comprise 85% of the survivors in that weight group. The follow-up attrition rate after two years is 12% in those who were smallest at birth, and 50% for those over 1,000 gm. In a subset of the total population, the heel lesions occurred in 16 of 20 infants as determined by a telephone survey of families in Tucson. We had not asked about the heel lesions when taking a history in clinic until we became aware of the problem. In addition, the lesions were not always seen in clinic because of the variable time of onset and duration. Those children had an average birth weight of 1,192 gm (range 830 to 2,170), gestational age of 29.5 weeks (range 27 to 34), and hospitalization of 68.9 days (range 40 to 112)i