A 10-year-old boy presents with heel pain worsened by running during football practice. Lateral foot radiograph shows increased density and mild fragmentation of the calcaneal apophysis. The most likely diagnosis is:
- A Kohler disease
- B Osgood-Schlatter disease
- C Sever disease ✓
- D Freiberg infraction
Correct answer: C. Sever disease
Explanation
Sever disease is a traction apophysitis of the calcaneal apophysis caused by pull of the Achilles tendon and plantar fascia in active children aged roughly 8 to 12 years. Sclerosis and fragmentation of the apophysis support the diagnosis clinically, though these changes can occur in asymptomatic children. Osgood-Schlatter affects the tibial tubercle, Kohler the tarsal navicular, and Freiberg a metatarsal head, none of which matches heel pain.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.