Other Causes of Foot Pain
Sever’s disease/Calcaneal apophysitis –an inflammation of the calcaneal apophysis in the
area of heel cord insertion. Generally manifests as
pain in the posterior
in the 6-10 year-old age group. Direct palpation shows tenderness. A
tight heel cord contributes to or exacerbates this condition. Treatment
is activity modification, NSAIDs, and heel cord stretching exercises.
Also see Achilles tendinosis
- An apophysis is a growth plate that does not contribute to the length of
the bone. The growth plate is weak and subject to micro-injury.
- the achilles tendon inserts into the calcaneal apophysis.
- Radiographic evaluation is usually normal.
- Sever’s Disease (like Osgood-Schlatter disease of the tibial tuberosity)
is an overuse syndrome seen in adolescents during their growth spurt.
- The most common sports to exacerbate heel pain are soccer, basketball,
gymnastics and baseball, especially sports that involve sprinting with
- Exam reveals tenderness
over the lateral and medial sides of the calcaneal apophysis and decreased
dorsiflexion of the ankle without swelling or redness. Findings are bilateral
- Accessory navicular– present with
painful bump on medial aspect of
- Kohler’s disease –osteochondrosis of navicular.
- Freiberg’s Infraction – osteochondrosisof head of second
CHLA Board Review 2005