Koh D, Goh Y, Yeo N. Calcaneal osteochondroma masquerading as plantar fasciitis: An approach to plantar heel pain - A case report and literature review. World J Orthop 2019; 10(9): 339-347 [PMID: 31572670 DOI: 10.5312/wjo.v10.i9.339]
Corresponding Author of This Article
Don Koh, MBBS, BSc (Hon), MRCS (Edin), Doctor, Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia Building Level 4, Singapore 169856, Singapore. don.koh@mohh.com.sg
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Sep 18, 2019; 10(9): 339-347 Published online Sep 18, 2019. doi: 10.5312/wjo.v10.i9.339
Calcaneal osteochondroma masquerading as plantar fasciitis: An approach to plantar heel pain - A case report and literature review
Don Koh, Yvonne Goh, Nicholas Yeo
Don Koh, Nicholas Yeo, Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169856, Singapore
Yvonne Goh, NUS Yong Loo Lin School of Medicine, NUHS Tower Block, Singapore 119228, Singapore
Author contributions: Koh D, Goh Y and Yeo N designed and performed the research; Koh D wrote the paper.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: All authors have seen and agree with the contents of the manuscript and there is no financial interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Don Koh, MBBS, BSc (Hon), MRCS (Edin), Doctor, Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia Building Level 4, Singapore 169856, Singapore. don.koh@mohh.com.sg
Telephone: +65-62223322 Fax: +65-62248100
Received: March 6, 2019 Peer-review started: March 8, 2019 First decision: April 16, 2019 Revised: May 15, 2019 Accepted: August 12, 2019 Article in press: August 13, 2019 Published online: September 18, 2019 Processing time: 208 Days and 8 Hours
Abstract
BACKGROUND
Heel pain is a common orthopaedic complaint, and if left untreated can be a source of chronic morbidity. Accurate diagnosis can be challenging, owing to the complex anatomy and multiple pain generators present in the foot. We aim to share our clinical experience managing an unusual case of chronic heel pain secondary to osteochondroma.
CASE SUMMARY
A 41-year-old obese male who works as a porter presented with a long-standing history of left plantar heel pain. He was assessed to have point tenderness over the plantar insertion of the calcaneus as well as a positive Silfverskiöld test. He was treated for plantar fasciitis and tight gastrocnemius but failed conservative therapies as well as surgical intervention. Magnetic resonance imaging revealed the presence of a pedunculated bony protrusion over the plantar aspect of the calcaneus. The decision was made for excision of the osteochondroma, and the patient has been pain-free since.
CONCLUSION
Osteochondromas are rarely symptomatic in skeletally mature patients. While most are benign with a very low risk of malignant transformation, surgical excision can yield excellent results and significant pain relief in symptomatic patients.
Core tip: Heel pain is a common orthopaedic complaint. If not treated correctly, it can lead to chronic morbidity and disability. Plantar fasciitis is diagnosed clinically. Advanced imaging is rarely required and used to exclude underlying sinister pathology. Osteochondromas of the calcaneum are rare. In symptomatic patients, excision can improve outcomes.
