Sever’s Disease

Question 1

Sever’s disease AKA

Answer 1

Calcaneal apophysitis

Question 2

Sever’s disease is a common cause of __________ pain in children aged __________

Answer 2

Common cause of heel pain in children aged 8-12yo

Question 3

What is Sever’s disease

Answer 3

Painful inflammation of the calcaneal apophysis caused by repetitive microtrauma on the unossified apophysis due to traction of the achilles tendon

Question 4

Closure of the calcaneus growth plate typically occurs around the age of ______

Answer 4

14

Question 5

Explain Sever’s disease in simple language

Answer 5

Sever’s disease happens when there is stress on the growth plate of the heel bone. Stress on the heel bone can occur with repetitive activities like running or jumping.

Question 6

What % of Sever’s disease is bilateral?

Answer 6

~60% bilateral

Question 7

Typical symptoms of Sever’s disease

Answer 7

Pain is usually absent when the child gets up in the morning
Heel pain that comes on during physical activity (e.g. weight bearing, running, jumping)
Heel pain that worsens after physical activity
Swelling in the heel
May limp or walk on tiptoes

Question 8

Exam findings in Sever’s disease

Answer 8

Tenderness on medial and lateral heel compression
Limited ankle dorsiflexion range secondary to tight Achilles tendon

Question 9

Investigations recommended in Sever’s disease

Answer 9

Clinical diagnosis. Xray not particularly helpful.

Question 10

Prognosis of Sever’s disease

Answer 10

Self-limiting. Resolves with maturation and the closure of the apophysis

Question 11

Management of Sever’s disease

Answer 11

Activity modification - avoid activities that exacerbate pain
Ice
Supportive footwear, heel cups (to reduce pressure on heel)
Analgesia
Achilles tendon stretches