Diagnosis

Sever’s Disease

Case Discussion

Calcaneal apophysitis, also known as Sever’s disease, typically affects children ages 7-15, and is thought to be secondary to repetitive microtrauma to the heel caused by traction of the Achilles tendon.

On MRI, edematous changes within the calcaneal apophysis may be appreciated, as well as fragmentation of the apophysis. 

Keys to the diagnosis include patient age and absence of direct trauma.

Key Images

Sever’s disease in a 12-year-old girl with severe left heel pain and swelling after jumping and landing on her heel 10 weeks prior

Sagittal T2 image of the left ankle shows hyperintensity of the calcaneal apophysis (red arrow).

References

  1. Hussain S, Hussain K, Hussain S, Hussain S. Severe’s disease: a common cause of pediatric heel pain. BMJ Case Rep 2013; 2013
  2. Dogan M, Doganay S, Koc G, Gorkem S, Ciraci S, Coskun A. Calcaneal Apophysitis (Sever’s disease): MRI findings. Journal of Nepal Paediatric Society 2016; 35(2) 172-174