Foot & Heel Pain
- Children:
- Severs disease (apophysitis) usually male aged about 10 years with increased density and fragmentation of the calcaneal apophysis
Raise heel and avoid strenuous activities, severe cases may require POP
- Adolescents:
- Calcaneal knobs (often bilateral) usually female 15 - 20 years
- Young Adults:
- Retrocalcaneal Bursitis (w/ Haglund's lump) above the Achilles tendon insertion or plantar fasciitis (enthesopathies)
- Older Adults:
- Plantar fasciitis
- Pagets may affect the calcaneum resulting in a chronic ache
- Chronic bone infection (Brodies abscess with sclerotic margin)
- Diabetes
- Entrapment of medial calcaneal branch of posterior tibial nerve
- Tarsal Tunnel Syndrome
Plantar Fasciitis:
- Pain at the attachment of the plantar fascia to the medial tubercle of the calcaneus. Treat with NSAIDs and orthosis, rarely needing release of plantar fascia.
Painful
- Kohlers disease
- (osteochondritis of the navicular) usually children less than 5 years old present with a painful limp and tender warm swelling over the navicular
Rest and strap for a few weeks results in relief and eventually ® normal looking navicular
Brailsfords disease similar to Kohlers but older women affected
- The "overbone"
- In adults with high arches, ridge of bone on dorsal surfaces of the med cunieform and 1st metatarsal- adjust shoes, bevel lump
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