Differentiating Heel Pain: Calcaneal Apophysitis (Sever's Disease) in Children vs. Plantar Fasciitis in Adults

Abstract

Heel pain is a common musculoskeletal complaint, but its underlying causes differ significantly across age groups, making accurate diagnosis essential for appropriate management. This poster compares calcaneal apophysitis (Sever's disease), the most common cause of heel pain in physically active children, with plantar fasciitis, a degenerative condition that predominantly affects adults. It highlights the differences in pathophysiology, age of onset, risk factors, location of pain, clinical presentation, imaging findings, and treatment strategies. Sever's disease is characterized by traction-related inflammation of the calcaneal growth plate and typically presents in children aged 8 to 15 years with activity-related posterior heel pain that improves with rest. In contrast, plantar fasciitis commonly affects adults aged 40 to 60 years and presents with plantar heel pain, particularly during the first steps in the morning, due to repetitive overload and degenerative changes of the plantar fascia. Although both conditions present with heel pain, distinguishing their clinical features allows clinicians to establish an accurate diagnosis, avoid unnecessary investigations, and implement age-appropriate conservative management. Early recognition and targeted treatment contribute to symptom resolution, improved function, and enhanced patient education.