Maselli Filippo, Storari Lorenzo, Barbari Valerio, Rossettini Giacomo, Mourad Firas, Salomon Mattia, Bisconti Mattia, Brindisino Fabrizio, Testa Marco
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova-Campus of Savona, 17100 Savona, Italy.
Sovrintendenza Sanitaria Regionale Puglia INAIL, 70126 Bari, Italy.
Healthcare (Basel). 2021 Apr 28;9(5):508. doi: 10.3390/healthcare9050508.
Haglund's syndrome (HS) is a painful condition that is caused by an exostosis of the posterior superior part of the calcaneus coupled with Achilles tendinopathy and retrocalcaneal bursitis. Both for the proper musculoskeletal assessment and for the differential diagnosis process of possible concurrent diseases deriving from other anatomical areas, the diagnosis of HS is still a challenge. A 41-year-old male amateur runner was diagnosed and treated for low back pain and referred leg pain by his general practitioner. Due to ineffective results, he self-presented to a physical therapist (PT) with intense right heel pain, radiating up to the leg and to the lumbopelvic region. The PT's examination and interview relating to the sports activities led to the correct diagnosis and a proper orthopedic referral. At the one-year follow-up, the patient reported regular pain-free marathon running. This case report highlights the central role of PTs working in direct access environments as primary care healthcare professionals for the management of musculoskeletal diseases, and their abilities in identifying patients with suspected pathologic conditions that may need referral for imaging, medical assessment or surgical intervention.
哈格伦德综合征（HS）是一种疼痛性病症，由跟骨后上部的外生骨疣，合并跟腱病和跟腱后滑囊炎引起。无论是进行适当的肌肉骨骼评估，还是对可能源自其他解剖区域的并发疾病进行鉴别诊断，HS的诊断仍然是一项挑战。一名41岁的男性业余跑步者被全科医生诊断为腰痛和腿部牵涉痛并接受治疗。由于治疗效果不佳，他自行前往物理治疗师（PT）处就诊，主诉右足跟剧痛，疼痛向上放射至腿部和腰骶部区域。PT对其体育活动进行的检查和问诊得出了正确诊断，并进行了恰当的骨科转诊。在一年的随访中，患者报告能够正常无痛地参加马拉松跑步。本病例报告强调了在直接就诊环境中工作的PT作为肌肉骨骼疾病管理的初级保健医疗专业人员的核心作用，以及他们识别可能需要转诊进行影像学检查、医学评估或手术干预的疑似病理状况患者的能力。
