Take an X-ray for Sever’s Disease?
It has never been recommended that an x-ray be taken for Sever’s Disease or Calcaneal apophysitis of the heel. The main reason is that it’s not detectable on x-ray. The appearance of the apophysis with or without Sever’s disease is the same, so it’s not much use. A minor reason is the exposing of kids to ionizing radiation, even though the dose is very small. For this reason, it’s hard to know why this research project was done: Do we really need radiographic assessment for the diagnosis of non-specific heel pain (Calcaneal apophysitis) in children? In which 70 x-ray’s of what was diagnosed as Sever’s were evaluated. In only one case did the x-ray change the diagnosis (to a simple bone cyst). They concluded that:
Neither the sclerosis nor the fragmentation of the apophysis could be used to establish the diagnosis of Calcaneal apophysitis. Therefore, obtaining radiographs as an initial step in their evaluation does not seem to be justified.
I guess that means we can keep doing what we have always been doing, but it is nice to have some evidence to defend the practice.
See Podiatry Arena for more on this study on Severs Disease and other Severs Disease topics.
Related posts:
