Calcaneal involvement in inflammatory disease.
The calcaneus may be involved in a variety of inflammatory conditions. Localized swelling, redness, and pain do not rule out metabolic pathologic conditions. One must initially determine that trauma has not created the malady. Personal or family history of systemic inflammatory disease is also necessary to create a proper differential diagnosis. Pedal radiographs can provide significant information in formulating an opinion. Osseous architecture, abnormal calcifications, and other alterations should be observed. Surrounding tissues may appear inflamed as well. Bone scintigraphy and nuclear medical studies can provide further information. Laboratory tests alone often are not diagnostic but, when coupled with other objective factors, can aid the clinician. Proper treatment must be determined once a diagnosis is established. Although many nonsurgical modalities are available, operative intervention is inevitable under certain circumstances. The clinician is cautioned that when surgery becomes necessary, appropriate perioperative considerations of the inflammatory process are mandatory.