Exostosis (osteochondrosis, apophysites, and haglund's deformity)

Abstract

Osteochondroses are characterized by disorderliness of endochondral ossification in the growing skeleton affecting various joint developments throughout the body. This process, which starts in adolescence, can cause permanent bony and/or articular alterations that require management in the adult phase of life. Examples in the foot and ankle include Freiberg's infraction, Köhler disease, sesamoid osteochondrosis, Sever's disease and Iselin's disease. Etiology, symptoms, diagnostics, non-operative management and surgical options are discussed. Haglund's deformity of the posterior calcaneus is a predisposing factor for painful retrocalcaneal bursitis. Diagnosis relies on weight-bearing lateral radiographs of the foot; numerous radiological parameters have been developed. Operative options include calcaneoplasty (open or arthroscopic) and calcaneal osteotomy. Most of these conditions can be treated non-operatively. Symptom control, immobilization, activity modification and appropriate rehabilitation can all play a role in a safe and timely return to sport.