14M 1 yr pain, no trauma, XRs. Please Help.

1 Comment / Cases / By
14 yr old male with 1 year ankle and foot pain, not specified, no trauma
history.
No prior imaging studies or reported medical history.
[image: 1.jpg]
Apropos my discomfort level with Peds MSK…..
I was reading the right side first and wondered if the trabeculae of the
posterior calcaneus looked a bit thick and sclerotic…then I realized it
was bilateral and the left side has sclerotic and lucent changes near the
apophysis….though the apophysis looks normal to me.
Is this stress related change? Infarcts?
Should I recommend Ankle MRI? Left or both sides?
[image: 2.jpg]
Additional Ankle XRs, AP and Obl of the feet look normal

Thanks.

Hilary

Loading

1 thought on “14M 1 yr pain, no trauma, XRs. Please Help.”

  1. hilary.umans
    hilary.umans
    I received several responses, some from Pediatric Radiologists.
    Most favor Healed or Healing Calcaneal Apophysitis or osseous stress “if he
    is very active”…..
    unfortunately I have no history / details other than 1 year pain without
    trauma.
    Some suggested CRMO and Bone Infarct.

    Since it is bilateral and more “severe” in appearance on the left, I have
    reported the case and recommended Left Ankle MRI for further evaluation, as
    it should be representative of what is going on on the right side.

    And this fro Tudor Hughes:

    This may give you some more comfort when reviewing peds.

    bonepit.com/Normal%20for%20age/Normal%20for%20age%20index.htm

    Essentially sets of images of each body part for each age and each sex,
    considered normal.

    Thanks for all your help!

    Hilary

    On Wed, Nov 16, 2022 at 10:22 AM hilary umans <hilary.umans@gmail.com>
    wrote:

    [gallery]

Leave a Comment