Bilateral Calcaneal Stress Fractures: A Case Report

Abstract

The majority of plantar heel pain is diagnosed as plantar fasciitis or heel spur syndrome. When history or physical findings are unusual or when routine treatment proves ineffective, one should consider an atypical cause of heel pain. Stress fractures of the calcaneus are a frequently unrecognized source of heel pain. In a normal populatıon, the possibility of calcaneal stress fractures must be borne in mind with patients who have bilateral heel pain. When a stress fracture is considered, clinicans have different imaging options. First of all, x-rays must be used to evaluate for any visible osseous pathology. If plain films are inconclusive, the clinician can proceed with a bone scan or Magnetic Resonance Imaging. In the literature, calcaneal stress fractures are mostly reported in soldiers or athletes, but our case is one of a 44-year-old housewife with bilateral heel pain treated as Achilles tendinitis and plantar faciitis for a long time. Her final diagnosis was bilateral calcaneal fracture by Magnetic Resonance Imaging.

Bilateral calcaneal stress fractures in two cats

“…Calcaneal stress fractures are a frequently unrecognised source of heel pain in humans and they are the second most common stress fracture in the foot (Aldridge , Tu & Bytomski , Imerci et al ). Calcaneal stress fractures can be bilateral and can occur in both juvenile and adult populations, but they are more common among active people such as athletes, sports enthusiasts and military personnel (Tu & Bytomski , Imerci et al ), which suggests that they are likely to arise as a result of bone fatigue. Similarly, calcaneal fractures in the racing greyhound are generally considered fatigue fractures (Gannon , Ost et al ).…”

Is There a Role for MRI in Plantar Heel Pain

“…23 Imerci et al reported a case of bilateral calcaneal stress fractures diagnosed with MRI scan in a patient who was clinically treated as plantar fasciitis and Achilles tendonitis for a long time. 24 Farber and Lovering reported a large multiloculated ganglion cyst in the tarsal tunnel diagnosed on MRI scan for persistent heel pain despite physical therapy. 25 Blume et al reported a case of large B-cell lymphoma of the calcaneus picked up by MRI scan in a patient with long-term heel pain.…”