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Remote Fellowship – Foot & Ankle Fundamentals – 11/2/2020

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Patient History

12-year-old girl with severe left heel pain and swelling after jumping and landing on her heel 10 weeks prior



Diffuse osteoedema (evident as diffuse T1 hypointensity and T2 hyperintensity) through the calcaneal apophysis. Mild diffuse enhancement through the calcaneal apophysis. Findings consistent with calcaneal apophysitis (Sever’s disease).

A similar, but less pronounced pattern of osteoedema is seen through the base of the 5th metatarsal apophysis.

No other osteoedema. No micro or macro trabecular fracture. No stress fracture. Unremarkable epiphyses.


Tibiotalar joint/talar dome: No osteochondral defect of the talar dome or tibial plafond.

Ankle mortise/syndesmosis: The ankle mortise is in anatomic alignment. No syndesmosis widening.

Chopart joint: Unremarkable.

Midfoot/hindfoot: Unremarkable.


High ankle: Intact.

Low ankle: Intact.

Subtalar/Chopart: Intact.




Sinus tarsi: Unremarkable.

Muscles: No traumatic muscle injury. No volumetric muscle atrophy.

Soft tissue: Small contusion involving the fat pad overlying the plantar aspect of the calcaneus. Otherwise unremarkable.

Plantar fascia: Intact.

Neurovascular complex/tarsal tunnel: Unremarkable. No evidence of entrapment neuropathy.

Intra-articular/loose bodies: None.


Osteoedema and enhancement of the calcaneal apophysis, consistent with calcaneal apophysitis (Sever’s disease). No fracture.