Calcaneal Apophysitis Research Articles

Hematogenous Calcaneal Osteomyelitis in Children

Heel pain is a frequent complaint in children due to intensive school and leisure-time sports. Heel pain accompanied by inflammatory signs has to be considered as osteomyelitis until the opposite is proven. From 1980 to 1989, twenty children were treated for acute or subacute osteomyelitis of the calcaneus (OMC) at the Department of Pediatric Surgery of the Children's Hospital of Lucerne. The schema of investigation comprising laboratory work-up, x-rays, scintiscanning and aspiration of the focus makes quick and accurate diagnosis possible. Exogenous osteitis of the newborn and calcaneal apophysitis in children must be differentiated; this is a prime consideration. Treatment includes surgical interventions (curettage, drainage) and long-term antibiotics. The course of the disease can be shortened, complications become avoidable and the rate of recurrence is diminished.

Prevention and management of calcaneal apophysitis in children: an overuse syndrome.

Calcaneal apophysitis (Sever disease) is a common cause of heel pain, particularly in the athletically active child. Eighty-five children (137 heels) with calcaneal apophysitis were reviewed. Both heels were affected in 52 (61%) patients. The most common associated foot condition was pronation, occurring in 16 patients. Sixty-eight patients complained that pain was made worse by a specific sport, with soccer leading the list. All patients were treated with a physical therapy program of lower extremity stretching, especially of the heel cords, and ankle dorsiflexion strengthening. Soft Plastizote orthotics or heel cups were used in 98% of patients. Proper athletic shoewear was advised. All patients improved and were able to return to their sport of choice 2 months after the diagnosis. There were two recurrences.

Osgood-Schlatter's disease in adolescent athletes. Retrospective study of incidence and duration.

During the period of 1976 to 1981, a total of 412 young athletes contacted the Turku Sports Medical Research Unit's (TSMRU) Outpatient Sports Clinic with 586 complaints. These records included 68 athletes with Osgood-Schlatter's disease (OSD), who were initially prescribed an average of 2 months' rest from any physical activity causing pain. Symptoms of tibial tuberosity pain occurred first at the average age of 13.1 years. According to the retrospective questionnaire, the pain caused complete cessation of training for an average of 3.2 months, and the disease interfered with fully effective training for an average of 7.3 months. According to a retrospective questionnaire given to 389 students (191 girls and 198 boys), 50 (12.9%) had suffered from OSD. Nearly one-half of the students, 193 (49.6%), had been active in sports at the age of 13, and 41 (21.2%) of them had suffered from OSD. In those students who were not active in sports, the incidence was only nine (4.5%; P less than 0.001). The incidence (32%) was higher in the siblings of the OSD patients of TSMRU who were active in sports than in the corresponding student group (21.2%). In a group of 22 patients from the TSMRU who had suffered from Sever's disease (calcaneal apophysitis), the incidence of OSD (68%) was significantly higher than in students who were active in sports (P less than 0.001).