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Tuesday, December 31, 2019

Calcaneal Stress Fracture: Last Patient of 2019


     My last official patient of 2019 was the 95 year old mother of a wonderful patient of mine. He brought her into the treatment room in a wheelchair with acute one day pain in her right heel. There was no incident of trauma. She has been struggling with pain in her left knee for a long time and perhaps is favoring her right foot. I went right to an MRI which they were able to get within the hour at our hospital fearing broken bone with this age and history until proven otherwise. Xrays can take weeks show subtle signs of a stress fracture, but the MRI images below (both T1 and T2) dramatically show the stress fracture non-displaced. I will keep her off her foot for the next month and start an Exogen bone stimulator if I can get approval for. Interestingly, her son fractured his heel bone doing ball room dancing 10 years ago in the same place. Genetic do give us weak spots. You can tell by the MRIs that the stress fracture was not due to weight bearing compression forces, but to the pull of the achilles tendon similar to many cases of Severs. Look how strong the achilles looks and the overall bone density seen on T2 throughout the area looks fine and not demineralized like in disuse atrophy. 



On a side note: This is my 2000th Blog Post since my start of blogging in March 2010! No one cares but me, but that will not stop me from raising a glass of champagne or bubbly tonight! Happy New Years. 


1 comment:

  1. So interesting Dr. Blake, it never fails; the left knee issues and the right heal. Same here, as you well know. Keep up the good work.

    ReplyDelete

Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.