Children with the heel pain of calcaneal apophysitis have more fragmentation of the secondary nucleus than children without this condition. Brazilian researchers suggest that may signify a mechanical cause of the disorder.
The sclerotic aspect of the secondary nucleus of the calcaneus is a normal feature in children, according to the researchers. Therefore, it should not be used to establish the diagnosis of calcaneal apophysitis, also known as Sever’s disease. Calcaneal apophysitis is a self-limiting condition that may interfere with walking and sports performance.
There has long been controversy about the significance of the radiographical changes in children with heel pain, chiefly because normal children may show wide variations in the radiographical aspects of the secondary ossification centre of the calcaneus at different ages. To assess the development of primary and secondary ossification centres of the calcaneus, the researchers, led by Jose B. Volpon of the department of orthopaedics and traumatology, University of São Paulo, School of Medicine of Ribeirão Preto, Brazil, studied radiographs from 392 healthy boys aged 6 to 15 years and from 69 boys aged 8 to 14 years with calcaneal apophysitis.
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