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hi,

15 yrs old student attended my OPD,
pain and selling over the post. heel region
for 2 months region.
he has sever tenderness and swelling around
TA.
pain is not subsided with rest and analgesics.

I suggested him for x ray. and noticed spike on right side
when compared with left (haglund's).

suresh

 

Hello Dr. Gandhi:


Yes, and I see increased soft tissue density at Kager's as well when compared to the other side.

Both symptomatic?
Obviously try rest, CAM boot, PT, Marcaine Injections, NSAIs...the usual.

If he has a talipes equinus and conservative treatment fails, you might consider lengthening as well as a debridement of the Posterior Os Calcis.

(I'm assuming he is negative for systemic etiologies.)

At 15, this may just be the beginning of chronic pain from tight TAs. Might be better to have him undergo the lengthening now (if you are sure it's indicated) at 15 rather than later.

What are your thoughts?

Steve