Foot-pain

Foot pain is a relatively common problem in children and adolescents. Most frequently the pain is localized at the heel, the mid- and forefoot are les s common sites of discomfort. In this article we discuss the etiology of pa in in theses cases, where the foot has a normal clinical aspect. Sever's di sease is most common in adolescents with strenuous athletic activity or wit h obesity. The calcaneal apophysis is overloaded. Usually the radiologic as pect of the calcis is normal. Treatment consists in reduction of the athlet ic activity, soft bedding of the heel in the shoes and reduction of weight. Avascular necrosis of the metatarsal head II or III(Freiberg's disease) is also relatively common, while necrosis of the navicular bone (Kohler's dis ease) is very rare. Treatment in these cases is always conservative. Pain c an also originate from tarsal coalition. While in the beginning the foot ha s a normal aspect, lateron a rigid flatfoot can develop. In unclear cases s tress fractures of the metatarsal bones; infections and tumors also have to be considered.