calcaneal epiphyseal osteochondrosis
Introduction
Introduction to calcaneus osteochondrosis This disease is also known as Sever disease or Haglund disease. It was first described by Haglund in 1907. Sever proposed this disease as ischemic necrosis of the calcaneal epiphysis in 1912. This disease occurs in 8-14 year olds who are sporty. More women than men, mostly on one side, but also on both sides. basic knowledge The proportion of illness: 0.0025% Susceptible people: no specific population Mode of infection: non-infectious Complications: ischemic necrosis
Cause
The cause of calcaneus osteochondrosis
Etiology, pathogenesis:
Due to the acute or chronic traction of the calcaneus during the weight bearing. The calcaneus is the second ossification center of the calcaneus. It is a distraction callus with strong Achilles tendon attachment. It appears at 7 to 10 years old and is one or several ossification centers. The center is fused with the calcaneus at the age of 15 to 18 years. The direct cause of the disease is that the Achilles tendon is acute or chronically pulled during the weight bearing, or the harder shoes are used to help excessively rub the heel and the calcaneal nodule. There may be many anatomical variations, and the normal density can be greater than the calcane itself. Therefore, in recent years, some scholars believe that it is a variation of normal osteophytes.
Prevention
Calcaneal osteochondrosis prevention
Avoid long-term strenuous exercise. Long-term, excessive, intense exercise or activity is one of the basic causes of bone hyperplasia. Exercise properly. Proper exercise, especially joint movement, can increase the pressure in the joint cavity, facilitate the penetration of joint fluid into the cartilage, and reduce the degenerative changes of articular cartilage. Excessive weight will accelerate the wear of articular cartilage, so pay attention to keep body weight. In addition, regardless of labor or leisure, it is necessary to change the posture frequently, and avoid the compression of the joint caused by the fixed posture.
Complication
Calcaneal osteochondrosis complications Complications ischemic necrosis
Juvenile calcaneus and osteochondrosis often occur in adolescents' rapid growth period. The main cause of most patients is the deformity of the calcaneus. Some of these patients may have joint pain, and 50% of patients complain of pain, mainly in the deformed part, which is aggravated after the activity. It usually decreases with the end of growth, and only 25% of patients have more typical symptoms after the maturity.
Symptom
Symptoms of calcaneus osteochondrosis Common symptoms Heel pain in the back of the heel... Heel blue black or black spot heel pain heel congestion
Mainly for the pain in the back of the heel, swelling and tenderness. The child walks with the toes or is slightly limp, running, jumping, walking too long or pulling the Achilles tendon attachment for too long, can make the pain worse, so the child Can not participate in sports activities, check for tenderness and mild swelling on the lower and lower sides of the calcaneus.
Examine
Examination of calcaneus osteochondrosis
On the X-ray film, there is soft tissue swelling at the attachment of the Achilles tendon, and the gap between the bone and the bone is widened. The shape of the bone is not neat, flattened or broken, smaller than the healthy side, high density, sometimes segmented. Shaped or spotted dense shadow, the part of the calcaneus corresponding to the epiphysis becomes rough and uneven, the bone process is often 2 to 3 ossification centers, and does not fuse with each other. It is pointed out that there are several ossifications in the normal calcaneal process. The center, and the shape can be different, the density is higher, the edge can also be irregular, similar to the performance of the disease, so the diagnosis should be closely combined with the clinical.
Diagnosis
Diagnosis and diagnosis of calcaneus osteochondrosis
diagnosis
Diagnosis can be established based on clinical manifestations and X-ray findings.
Differential diagnosis
First, the heel bone hyperplasia heel bone hyperplasia is commonly known as calcaneus. It is a kind of hyperosteogeny, the symptoms are heel tenderness, pain in the soles of the feet, heavy in the morning, light in the afternoon, the first step of getting up under the pain can not be tolerated, when it is light and heavy, the heel does not dare to use when walking, there are stone sarcophagus, The feeling of acupuncture, the symptoms are relieved after the activity is opened, and the long bone spurs in the calcaneus are more common in middle-aged and elderly people. With the increase of age, many tissues of the human body will degenerate, especially the heel area is subjected to a lot of pressure, and the duration of the pressure is also long. In addition, the friction and impact of the heel part are indispensable during walking. Related tissues are prone to degenerative changes, which induce the occurrence of foot spurs (bone hyperplasia).
Second, follow the fat paditis
The disease is heel pain, with more walking, weight bearing, physical decline, recent weight gain, the sole is thin. The tender point is behind the midpoint of the heel, which is characterized by sitting up for a while or awakening after getting up. When the pain is obvious, the activity will be obviously relieved for a while. The reason is that the pain of inflammation stimulates the blood flow with the compression of the heel and the ground, the inflammatory substances are partially taken away, and the pain is relieved. The inflammatory substances are at rest. Produced and accumulated in this. Therefore, there will be pain in the ground again. The part is in the fat pad, and the nature is aseptic inflammation.
