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Tuesday, 24 May 2011

Calcaneal apophysitis - Sever`s disease

osteochondrosis of the apophysis of the os calcis

  • apopohysis becomes dense and sclerotic and undergoes fragmentation

  • difficult to differentiate from normal finding on plain films
  • apophysis normally varies greatly and may ossify from several centers

This is a condition that affects the cartilage growth plate and the separate island of growing bone on the back of the heel bone. This growth plate is called the physeal plate. The island of growing bone is called the apophysis. It has the insertion attachment of the achilles tendon, and it has the attachment of the plantar fascia. This island of bone is under traction from both of these soft tissue tendon and tendon-like attachments.

Sever disease is painful irritation and inflammation of the apophysis (growth plate) at the back of the calcaneus (heel bone), where the Achilles tendon inserts.

Sever disease is caused by repetitive tension and/or pressure on the growth center. Running and jumping generate a large amount of pressure on the heels.

as is shown below, however, fragmentation of the apophysis is a normal finding;
ankle trauma 2 lat1
Normal heal of a child

Normal heal 2