Which of the following is not a characteristic of calcaneal apophysitis?

• A. Aggravated by physical activity
• B. Self-limiting pain
• C. Anterior heel pain
• D. Patients often present with a limp

Answer: (C)

Calcaneal apophysitis, commonly known as Sever's disease, primarily affects the heel of growing children and adolescents. It is characterized by an inflammation of the growth plate (apophysis) of the calcaneus (heel bone), often due to repetitive stress and strain from activities such as running and jumping.

The statement regarding anterior heel pain is inaccurate within the context of calcaneal apophysitis. This condition typically presents with pain localized to the posterior aspect of the heel, rather than the anterior region. Since the pain is a result of inflammation at the heel's growth plate, the symptoms are primarily felt at the back of the heel, which is critical when differentiating from other conditions that may cause anterior heel pain, such as plantar fasciitis or Achilles tendon issues.

In contrast, the other characteristics are consistent with calcaneal apophysitis. The condition is indeed aggravated by physical activity as the stresses from running and jumping exacerbate the inflammation. It is also considered self-limiting, indicating that it usually resolves on its own with time and rest. Additionally, it is common for affected children to present with a limp due to discomfort while walking or participating in sports.

Understanding these characteristics helps in the correct diagnosis and