Imaging case

Fábio Barroso, João Nascimento


Introduction: Calcaneal osteomyelitis is a relatively rare entity and may be underdiagnosed for not being correctly recognized.

Case report: An eight-year-old white boy presented with heel pain and an inability to weight-bearing. The condition was misdiagnosed as Sever’s disease so he was discharged with symptomatic treatment. Magnetic resonance imaging two weeks after clinical onset revealed diffuse osteomyelitis of his calcaneum. He underwent six weeks of antibiotics administered intravenously, with clinical improvement. In one year of follow-up he has no evidence of complications.

Discussion: Paediatricians should include calcaneal osteomyelitis as a differential diagnosis in any child/adolescent presenting with indolent heel pain. Delays in the diagnosis can lead to disastrous complications.


Calcaneal; osteomyelitis; Sever’s disease

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