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An 11-year-old male presents to urgent care complaining of bilateral heel pain, right worse than left. The patient denies recent trauma and reports experiencing increased pain when running. He has not tried any treatment and denies any history of similar episodes in the past.
Physical examination reveals bilateral pes planus and decreased dorsiflexion of the feet with weightbearing lunge against the wall. Pain is elicited with calcaneal compression test. The patient is noted to be favoring his right heel with barefoot gait. The Thompson’s test is normal, pulses are normal, and his sensation is intact with brisk cap refill to bilateral toes. A right calcaneal x-ray is ordered.
Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
