Calcaneus secundarius as a cause of rearfoot pain

NewsBot · Jun 8, 2015

Members do not see these Ads. Sign Up.
http://www.biomedcentral.com/content/pdf/s13256-015-0595-7.pdf

Calcaneus secundarius – a relevant differential
diagnosis in ankle pain: a case report and review of
the literature
Daniel Krapf, Sebastian Krapf, Christian Wyss
Journal of Medical Case Reports

Introduction
Accessory ossicles of the foot are a common finding. Although mostly asymptomatic, they
can gain clinical relevance by trauma or stress on the complex biomechanical system of the
foot. There are few reports on the entity of symptomatic calcaneus secundarius. Furthermore,
the current literature does not address the need for awareness of calcaneus secundarius as a
differential diagnosis in cases of persistent posttraumatic ankle pain.
Case presentation
We present the case of a 51-year-old Indo-European man with a medical history of persistent
load-dependent ankle pain over 3 decades. At presentation after an acute ankle sprain, we
diagnosed a traumatized calcaneus secundarius. Surgical excision led to a complete recovery.
More than 1 year postoperative he is still asymptomatic.
Conclusions
With the presented case and review of the literature we demonstrate the clinical relevance of
calcaneus secundarius. Depending on size and alignment, calcaneus secundarius can alter the
biomechanics in the subtalar region generating pain at the ankle. If a patient has persistent
sinus tarsi syndrome, a painful limited subtalar range of motion or repetitive ankle sprains,
then calcaneus secundarius should be considered in differential diagnosis. Likewise when a
fracture of the anterior process of the calcaneus or a calcaneonavicular coalition is suspected,
calcaneus secundarius should be considered a possible diagnosis by all clinicians confronted
with foot and ankle pain
Click to expand...

NewsBot · May 6, 2018

Endoscopic resection of symptomatic os calcaneus secundarius
Tun Hing Lui
The Foot; 30 April 2018

Highlights
•Os calcaneus secundarius is an accessory ossicle at the anterolateral process of the calcaneus.
•It may cause chronic pain and limitation of inversion motion after inversion ankle sprain.
•It can be resected endoscopically.
Click to expand...

Os calcaneus secundarius is an accessory ossicle resulting from a secondary ossification center of the anterior facet of the calcaneus. It may cause chronic pain and limitation in inversion motion after inversion ankle sprain. Excision of the ossicle is indicated if the symptoms do not resolve with conservative treatment. We report a case of symptomatic os calcaneus secundarius which was successfully resected endoscopically.
Click to expand...

NewsBot · Mar 30, 2019

Tibial spastic varus foot caused by os calcaneus secundarius: A case report
TsuyoshiOhishiaTomotadaFujitaaTatsuyaNishidaaMitsuruAsukaiaDaisukeSuzukibYukihiroMatsuyamac
The Foot; 25 March 2019

Highlight
•Tibial spastic varus foot caused by os calcaneus secundarius, which has not been reported to date, was successfully treated by resection of that rare accessory bone.
Click to expand...

Peroneal spastic flat foot caused by tarsal coalition is well known; however, tibial spastic varus foot is a rare clinical entity also caused by tarsal coalition in most cases. The os calcaneus secundarius is a rare accessory bone between the anterior process of the calcaneus and the navicular bone. Here, we present the case of a 29-year-old woman with tibial spastic varus foot caused by os calcaneus secundarius. Operative excision of the os calcaneus secundarius completely resolved the varus deformity. This is the first case report involving tibial spastic varus foot caused by os calcaneus secundarius.
Click to expand...

NewsBot · Oct 2, 2019

Os calcaneus secundarius, a relevant differential diagnosis to fracture or pseudarthrosis of processus anterior of the calcaneus: a CT morphologic description.
Hennings R et al
Surg Radiol Anat. 2019 Sep 28

PURPOSE:
A fracture or a pseudarthrosis of the processus anterior calcanei (PAC) as well as a traumatized Os calcaneus secundarius (OCS) is often overlooked. A clinical or conventional radiological differentiation of these is uncertain. Therefore, a CT scan is recommended. The aim of the study was to identify CT morphological differentiators between OCS and pathologies of PAC.

METHODS:
All CT scans at our trauma center level I from 2010 to 2014, which imaged the entire foot, performed after acute trauma or postoperative control were retrospectively re-examined for OCS, other accessory ossicles (oAOS), fracture or pseudarthrosis of PAC and analyzed for specifiers.

RESULTS:
In 611 CT examinations, 14 (2.3%) accessory ossicles (AOS) at the PAC were detected. 12 (86%) were identified as typical OCS and 2 (14%) as oAOS. 56 (9.2%) pathologies were detected. Of these, 44 (79%) were declared as fractures and 12 (21%) as pseudarthrosis. 7 OCS (58%) and 25 (46%) of the pathologies were not mentioned in the initial CT reports. The main differentiators of OCS to fracture of PAC were the anteromedial localization into a concave notch at the calcaneal facet at PAC and the continuous corticalization. With increasing size, radiological osteoarthritic signs at the OCS were frequent (p ≤ 0.05).

CONCLUSIONS:
The study confirms that AOS or pathologies at the PAC often are not exactly described in CT report. In the context of foot trauma, attention should be paid to this region. Based on the presented differentiation criteria, a precise distinction can be made with the help of a CT.
Click to expand...

NewsBot · Apr 25, 2021

A case of an injured calcaneus secundarius in a professional soccer player
Kepka Sabrina, Morel Marc, Garnier Franck, Pietra François, Marjanovic Nicolas, Zeller Pascal, Bilbault Pascal, Kremer Stéphane & Bierry Guillaume
BMC Musculoskeletal Disorders volume 22, Article number: 374 (2021)

Background
The calcaneus secundarius (CS) is an accessory ossicle of the anterior facet of the calcaneus and is usually asymptomatic. This accessory bone can be frequently mistaken for a fracture of the anterior process of the calcaneus. Few reports of symptomatic CS have been published, and physicians need to be familiar with imaging strategies when encountering chronic ankle pain or in case of suspicion of fracture of the anterior process of the calcaneus.

Case presentation
We describe the case of symptomatic CS in a professional soccer player injured during a match. First, computed tomography showed a large CS. Second, magnetic resonance imaging (MRI) demonstrated synchondrosis between the CS and the calcaneus, as well as edema (high MR T2 signal) within it, corresponding to posttraumatic edema. The patient was successfully treated with nonsteroidal anti-inflammatory drugs and physiotherapy; no surgical management was necessary. At the 4-week follow-up, he was pain-free and returned to activity.

Conclusion
This case illustrates the role of imaging for the diagnosis of CS in cases of acute pain of the foot. CT, as well as MRI, helped to confirm the diagnosis of CS traumatized synchondrosis, which can be mistaken for a fracture.
Click to expand...

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Trabecular structure of the calcaneus

Abnormal Ontogenetic Development of the Calcaneus resulting in the PreClinical Clubfoot Deformity

calcaneus osteotomy with first metatarsal osteotomy.

Calcaneus fractures

Calcaneal varus angle change in normal calcaneus

Plantarflexed Calcaneus in longer leg, how to treat?

Aneurysmal bone cyst of the calcaneus

Share This Page