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Aseptic necrosis of the calcaneus tumor usually appears between the ages of 9 and 13 and is manifested by pain in the heel tumor after long walks, runs, and intense exercise. The cause of the disease may be hormonal disorders or genetic predisposition.
What is sterile calcaneal tumor necrosis?
Aseptic heel tumor necrosis is otherwise known as Haglund’s disease. It mainly affects children and adolescents in the period of growth (more often boys than girls) and people practicing sports, e.g. running. The duration of this ailment is usually 18 months, the prognosis is relatively good. The patient limps while walking, and reduces the discomfort by walking on his toes. There is a slight swelling of the calcaneal tumor, painful pressure and increased pain with passive dorsal flexion of the foot. The disease at an advanced stage is very troublesome and disrupts everyday functioning, therefore patients rarely postpone a visit to the doctor. Of course, not every pain in the heel is indicative of a sterile calcaneus tumor necrosis. The causes of this condition are not fully known, and the studies conducted so far indicate that the occurrence of lesions may be related to genetic predisposition, micro-injuries or hormonal disorders.
Causes of aseptic heel tumor necrosis
Aseptic necrosis of the calcaneus tumor results from arterial ischemia that is confined to the posterior part of the heel. This ischemia leads to minor bone tissue necrosis and sometimes even to the degeneration of the calcaneus. A bone growth of the calcaneus is formed, which causes pain due to pressure. In children, Haglund’s disease is associated with disturbances in the proper development of the calcaneus, and in adults it is caused by various types of overload, e.g. during sports.
Aseptic necrosis of the calcaneus tumor – symptoms
The first symptom of the disease is pain in the heel below the Achilles tendon insertion. It usually occurs after overloading, for example after playing football or walking for a long time. The development of the disease causes the pain to worsen and causes limping. In addition, the patient’s heel may have a slight swelling, blisters and soreness at the dorsiflexion of the foot, due to the attachment of the Achilles tendon pulling the affected area. Also, wearing shoes or touching the heels causes pain. Symptoms occur intermittently and are not always bothersome enough for the patient to take immediate action. It is worth knowing, however, that untreated and prolonged aseptic necrosis of the calcaneus tumor may lead to inflammation of the Achilles tendon. Therefore, it is worth visiting a doctor when the pain continues and does not subside.
important: in addition to heel pain, there may also be slight redness and swelling due to inflammation of the synovial bursa.
Diagnosis and treatment of aseptic heel tumor necrosis
Heel pain does not always indicate sterile calcaneal tumor necrosis, as similar symptoms occur in the course of the heel spur. For this reason, an X-ray examination should be performed to find the answer to the question of what disease we are dealing with. The treatment of Haglund’s disease consists of relieving the heel tumor by using weight-relief insoles, increasing the heel, warm baths or shoes without a heel. In the period of exacerbation of symptoms, it is necessary to avoid longer walking, runs, marches and to spare the limb. Painkillers, and sometimes even steroids, are often used at the same time.
The orthopedist may also refer the patient to rehabilitation. Properly selected exercises and treatments improve the prognosis of the disease. However, if rehabilitation is not achieving the expected benefits, surgery should be considered. Surgical treatment is based on the removal of the growths formed on the heel tumor. In addition, thanks to the development of medicine, it is possible to restore the proper density of the tissue, which then does not exert pressure on the diseased area. After the procedure, the patient should have the (partially) immobilized foot for several weeks. Convalescence takes about six weeks.
Note: To avoid complications and relapse, consult your doctor about what sports activities can be performed after the surgery.
Prognosis – good. There are no known methods of preventing the disease.