A painful foot in a young boy
- By: Baskaran Komarasamy, Ramanan Vadivelu
A 12-year-old white boy presented to the emergency department with a history of recurrent painful left foot. In the past, he had noticed vague dull ache in his left hindfoot, which occasionally became painful on severe exertion. Analgesics and rest for a few days eased his pain during these acute episodes. A detailed history and physical examination of his left foot found mild swelling and tenderness over the dorsum of the foot and in the mid-tarsal region. He had the full range of movements in all the joints of his forefoot and mid-foot. Movement in his hindfoot was slightly restricted (figure).
Most tarsal coalitions are asymptomatic or minimally symptomatic. The severely symptomatic ones are initially treated by non-operative methods using foot supports and shoe heels to correct the deformity, which helps to relieve pain, along with analgesics. Surgical treatment is indicated in patients for whom the conservative treatment fails. The