Sever's Disease of the Pediatric Population: Clinical, Pathologic, and Therapeutic Considerations

Abstract

Sever's disease is an underreported prevalent pediatric condition that causes heel pain in children worldwide. It is often described as an overuse injury that can present with either unilateral or bilateral heel pain. Even though the exact mechanism of injury is unknown, it is often thought it involves repetitive stress and pressure on the calcaneal growth plate. Diagnosing Sever's disease mainly relies on a thorough clinical investigation and physical examination, with a positive squeeze test usually sufficient to establish diagnosis. Nevertheless, radiographic imaging can help exclude other differential diagnoses. Therapeutic options of Sever's disease are mostly conservative, and these include rest, physical therapy, kinesiotherapy, and orthoses. Educating parents and coaches on the symptomatology and presentation of Sever's disease is pivotal for the establishment of efficient preventive interventions and earlier diagnoses. This study presents a case of a pediatric patient with Sever's disease and offers medical insight into the diagnostic, clinical, pathologic, and therapeutic characteristics of this condition, in light of the current existing literature.

Keywords: Calcaneal apophysitis; Overuse injury; Pediatrics; Sever’s disease.

Figure 1.

Radiographic imaging (X-ray) of the patient revealing no abnormalities or fractures.

Figure 2.

Anatomy of Sever’s disease.

Figure 3.

The calcaneal squeeze test.