- This is a transient condition that affects the calcaneal apophysis at the insertion of the Achilles tendon.
- Usually in active children where inversion/eversion of the calcaneus causes a torsional effect on the apophysis.
- In severe cases, there may be avascular necrosis.
- Pain directly around the back of the calcaneus, especially when squeezed.
- Pain on exercise or stretching the Achilles tendon.
- Typically affecting boys aged 9-13.
- Walking on toes.
Tests and Imaging
- Clinical examination and a detailed history allow diagnosis.
- Xray is often inconclusive. Bone scan or MRI may be more conclusive, particularly in recalcitrant cases.
- Activity modification to reduce or stop any activity that causes pain.
- Short term NSAIDs, such as ibuprofen.
- Podiatry for stabilising orthoses (to limit inversion/eversion of calcaneus) and footwear advice.