Department of Orthopaedic Surgery, James Cook University Hospital, Marton Road, Middlesbrough TS43BW, United Kingdom.
Foot Ankle Surg. 2011 Jun;17(2):e25-7. doi: 10.1016/j.fas.2010.10.004. Epub 2010 Dec 9.
Benign lytic lesions of the calcaneus are rare and are usually asymptomatic. We report this case of a 55-year-old man with bilateral non-traumatic plantar heel pain, which was treated conservatively as plantar fasciitis. At three months follow-up, the patient had complete relief of symptoms in the left heel with partial relief of symptoms on the right side. However under the insistence of the patient an X-ray was taken, which revealed an expansile lytic lesion of the right calcaneus and a normal left heel. CT-scan revealed an expansile lytic lesion on the right calcaneus and an early lytic lesion in the left calcaneus. Following surgical intervention, the diagnosis was confirmed as intra-osseous lipoma and the patient was completely symptom free at two-year follow-up. Patients presenting with non-traumatic heel pain should be explained about the possible causes of heel pain, and should be offered X-ray at the first visit. In patients with X-ray showing unilateral lipoma of the calcaneus, CT scan should be offered to rule out involvement of the opposite side.
跟骨良性溶骨性病变罕见，且通常无症状。我们报告一例 55 岁男性，双侧非创伤性足底足跟疼痛，最初被误诊为足底筋膜炎而接受保守治疗。随访 3 个月时，左侧足跟疼痛完全缓解，右侧足跟疼痛部分缓解。但在患者的坚持下拍摄 X 线片，结果显示右侧跟骨膨胀性溶骨性病变，左侧跟骨正常。CT 扫描显示右侧跟骨膨胀性溶骨性病变和左侧跟骨早期溶骨性病变。行手术干预后，诊断为骨内脂肪瘤，患者在两年随访时完全无症状。对于出现非创伤性足跟疼痛的患者，应向其解释足跟疼痛的可能原因，并在首次就诊时提供 X 线片。对于 X 线片显示单侧跟骨脂肪瘤的患者，应行 CT 扫描以排除对侧受累。
