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Sever Syndrome

Michelle Henne, MD and D. Harrison Youmans, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A frequent cause of heel pain in children and adolescents resulting from a traction apophysitis of the calcaneal apophysis

  • Frequently associated with repetitive use and sports partici...

DIAGNOSIS

HISTORY

  • Chronic heel pain with insidious onset exacerbated by activity

  • May be exacerbated by footwear with poor heel cushioning

  • Mean age of presentation is 8 to 12 years old.

  • Pain is bilateral i...

TREATMENT

GENERAL MEASURES

Treatment of this condition involves conservative therapy. This condition is self-limiting and will resolve with closure of apophysis. 

MEDICATION

First Line

NSAIDs, such as ibu...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

A follow-up evaluation would be appropriate in 4 to 8 weeks to monitor for resolution of symptoms. 

Patient Monitoring

  • This is a benign, self-limited condition.

  • No a...

REFERENCES

1
Suzue N, Matsuura T, Iwame T, et al. Prevalence of childhood and adolescent soccer-related overuse injuries. J Med Invest.  2014;61(3–4):369–373. [View Abstract on OvidMedline]
2
Tu P, ...

ADDITIONAL READING

  • Frank JB, Jarit GJ, Bravman JT, et al. Lower extremity injuries in the skeletally immature athlete. J Am Acad Orthop Surg.  2007;15(6):356–366. [View Abstract on OvidMedline]

  • Mi...

SEE ALSO

Little Leaguer’s Elbow (Medial Apophysitis); Osgood-Schlatter Disease (Tibial Apophysitis) 

CODES

ICD10

M92.8 Other specified juvenile osteochondrosis 

SNOMED

  • 23890000 Calcaneal apophysitis

  • 15638811000119102 Bilateral calcaneal apophysitis

CLINICAL PEARLS

  • Sever disease is most frequent cause of heel pain in children and adolescents.

  • Treatment is conservative.

  • The condition is typically benign and self-limited with resolution of symptoms e...

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