Sever's Disease in Mandiana (North-East Guinea): A Case Report and Review of the Literature

Abstract

Introduction: Sever's disease or calcaneal osteochondrosis of the posterior apophysis affects adolescent athletes between 8 and 15 years of age, boys are more affected in about 60% of cases and the involvement is uni or bilateral, described in 1912 by the surgeon James Warren Sever. Objective: To present the first case of Sever's disease in Mandiana, supported by a review of the literature. Clinical Case: This was an 11-year-old adolescent, living in Mandiana, a soccer player (right lateral), playing with his right foot, who consulted for a right posteroinferior talalgia, progressive, of mechanical appearance, triggered by walking and physical activity, calmed by rest or by taking non- steroidal anti-inflammatory drugs (NSAID). No notion of taking fluoroquinolone-based medication, no signs suggestive of an infectious focus, particularly auto-rhino-laryngology (ENT) and dental, or tumors. The painful swelling (VAS 9/10) on palpation of the medial and lateral heel cup with degree 2 flat foot, the densification and fragmentation of the posterior calcaneal process on the right foot profile radiograph allowed the diagnosis of Sever's disease. The treatment was based on oral ibuprofen 400 mg three times a day for three weeks, diclofenac gel to rub the ankle, and the cessation of physical and sports activity for three months which gave a favorable outcome by the regression of pain (VAS at 1/10) and the normal resumption of walking. Conclusion: Sever's disease is a common condition in growing children, its diagnosis is clinical, radiology is used for differential diagnosis, and rest is essential in its management.