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Hi everyone,
Looking for a second opinion. 73 y/o Female presents with typical symptoms of plantar fasciitis but more so and more relevant to this discussion pain on the lateral calcaneal tuberosity. Plantar fasciitis was treated and symptoms resolved however lateral tuberical pain continues. Initially thought the lateral pain was radiating from the plantar fascia symptoms however when non improved xray was sought. Treatment has been to date to provide cuhsion to existing orthotic and deflection but patient still experiences pain albeit reduced and especially discomfort barefoot. The xray report did report on this area typical in my area. I feel it might be an osteo - condroma or similar, looking for a second opinion. The doctor did not know and he sent it to a specialist for an opinion but I havn't heard back yet.

 

Just realised there is a name appearing on my attachment. Can't seem to be able to delete attachment and add another minus the name. Made sure it wasn't on the xray. Does anyone know how to do this and also I want to adjust some spelling mistakes.

 

xray attached and correct spelling of "osteochondroma"

 

Sounds like plantar fat pad atrophy. Try a heel cushion or an orthotic with PPT heel build up.
Good Luck
Teri Green
Atlas Biomechanics

 

thanks Teri
query is on the bone change,there is no fat pad atrophy. She already has a cushioned heel pad plus deflection over the site of the bone protrusion as mentioned above..... pain continues. Is this a osteochondroma???/

 

This may be nothing, however, since she does have symptoms in the area a CT scan would help.

I've seen enlargements here quite a few times with axial calcaneal or HB views. Usually a normal variant. The cortex in intact, no inclusions, no trabecular disruption, no new activity.

Steve

 

thanks Steve
for your reply
have a catscan now and nil was scene so appears a normal variant ...thank you again. Have had 2 other opinions from colleagues and they also felt it was a stress variant with the slight change in trabecular pattern but normal.
I am going to review the patient and orthotic now she has had it longer. Maybe consider expanding the lateral counter of the device ?