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Sever Disease (Calcaneal Apophysitis)

  • Christopher W. Bailey and Mary L. Cannon
Published/Copyright: May 1, 2014
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 114 Issue 5

An 11-year-old girl complained of pain in her right heel. The pain had been ongoing for several weeks, caused a limp, and at times precluded the patient from performing tumbling maneuvers in cheerleading practice. On physical examination, there was no ecchymosis, edema, or asymmetry compared with the contralateral heel. Medial and lateral heel compression where the calcaneal apophysis attaches to the main body of the calcaneus reproduced the patient's pain, suggesting Sever disease, or calcaneal apophysitis. Radiographs were ordered to ensure that no traumatic injury occurred and revealed a nonfractured bipartite right posterior calcaneal apophysis with increased sclerotic density (image, arrow). The inflammation of Sever disease is self-limiting, and the patient healed over time with increased rest.

Although Sever disease affects individuals differently, researchers have found that children with this disease experience a decrease in quality of life.1 Diagnosis can often be made with clinical findings alone,2 but further evaluation with radiography is advised as a more malignant finding could be overlooked.3

From the Department of Radiology at the West Virginia University School of Medicine in Morgantown
Address correspondence to Christopher W. Bailey, DO, West Virginia University Department of Radiology, Room 2278 HSS, PO Box 9235, Morgantown, WV 26506-9235. E-mail:

  1. Financial Disclosures: None reported.

  2. Support: None reported.

References

1 Scharfbillig RW Jones S Scutter S . Sever's disease—does it effect quality of life?Foot (Edinb). 2009;19(1):36-43. doi:10.1016/j.foot.2008.07.004.10.1016/j.foot.2008.07.004Search in Google Scholar PubMed

2 Kose O . Do we really need radiographic assessment for the diagnosis of non-specific heel pain (calcaneal apophysitis) in children?Skeletal Radiol.2010;39(4):359-361. doi:10.1007/s00256-009-0774-y.10.1007/s00256-009-0774-ySearch in Google Scholar PubMed

3 Rachel JN Williams JB Sawyer JR Warner WC Kelly DM . Is radiographic evaluation necessary in children with a clinical diagnosis of calcaneal apophysitis (sever disease)?J Pediatr Orthop.2011;31(5):548-550. doi:10.1097/BPO.0b013e318219905c.10.1097/BPO.0b013e318219905cSearch in Google Scholar PubMed

Received: 2013-06-15
Revised: 2013-08-20
Accepted: 2013-08-29
Published Online: 2014-05-01
Published in Print: 2014-05-01

© 2014 The American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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https://doi.org/10.7556/jaoa.2014.081
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. Editorial
  2. The Journal of the American Osteopathic Association: The Next Generation
  3. Wikipedia: Proceed With Caution
  4. Letters
  5. Osteopathic Graduate Medical Education: New Research Standards Needed
  6. An Unexpectedly Progressed Lumbar Herniated Disk
  7. Response
  8. AOA Communication
  9. Official Call
  10. Original Contribution
  11. Somatic Dysfunction and Use of Osteopathic Manual Treatment Techniques During Ambulatory Medical Care Visits: A CONCORD-PBRN Study
  12. Association of Low Back Pain, Somatic Dysfunction, and Lumbar Bone Mineral Density: Reproducibility of Findings
  13. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions
  14. Clinical Practice
  15. Effect of Osteopathic Manipulative Therapy in the Attentive Performance of Children With Attention-Deficit/Hyperactivity Disorder
  16. Management of Ionizing Radiation Injuries and Illnesses, Part 2: Nontherapeutic Radiologic/Nuclear Incidents
  17. Special Communication
  18. The ‘little m.d.’ or the ‘Big D.O.’: The Path to the California Merger
  19. The Somatic Connection
  20. Manual Therapy Shown to Be Effective for Tension-Type Headache
  21. OMT Improves Acute Hemodynamic Control in Pregnancy by Means of Improved Venous Return
  22. Several Manual Therapies Proven Beneficial for Patients With Chronic Neck Pain
  23. How Much of Your Low Back Pain Is Really in Your Head?
  24. Mechanical Changes of the Brain During Sleep Clear Metabolites and Provide Key Mechanism for Sutherland's Cranial Respiratory Impulse
  25. G.I. Joe: Could Visceral Osteopathy Help Fight the War against IBS?
  26. Clinical Images
  27. Sever Disease (Calcaneal Apophysitis)
  28. In Your Words
  29. To an Intern: What if You Were the Patient?
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