Huisarts en wetenschap

, Volume 55, Issue 6, pp 260–265 | Cite as

Hielpijn bij kinderen

  • J. I. Wiegerinck
  • P. A. Struijs
  • B. Oudhof
  • H. C. P. M. van Weert
Nascholing

Samenvatting

Wiegerinck JI, Oudhof B, Van Weert HCPM, Struijs PA. Hielpijn bij kinderen. Huisarts Wet 2012;55(6):260-5.

Niet-traumatische hielpijn bij kinderen kan diagnostische problemen geven omdat verschillende aandoeningen vergelijkbare klachten geven. Vanwege de verschillen in ernst en behandeling is een differentatie echter wel van belang. De ziekte van Sever (apofysitis calcanei) is verreweg de meest voorkomende oorzaak, in de differentiaaldiagnose staan bij kinderen tamelijk zeldzame aandoeningen als fasciitis plantaris, retrocalcaneaire bursitis, stressfractuur van de calcaneus, posterieur enkelimpingement en tendinopathie van de achillespees. Meestal is de diagnose goed te stellen met een gerichte anamnese en een grondig lichamelijk onderzoek, maar in sommige gevallen (stressfractuur) is beeldvormend onderzoek aangewezen . De behandeling is bijna altijd conservatief. Als de klachten lang aanhouden, is doorverwijzing naar de orthopedisch chirurg altijd geindiceerd.

Abstract

Wiegerinck JI, Oudhof B, Van Weert HCPM, Struijs PA. Heel pain in children. Huisarts Wet 2012;55(6):260-5.

Non-traumatic heel pain in children can be a diagnostic problem because several disorders have similar symptoms. However, because of differences in prognosis and treatment, it is important to establish the diagnosis. Sever’s disease (calcaneal apophysitis) is by far the most common cause of heel pain, but the differential diagnosis in children includes relatively rare conditions such as plantar fasciitis, retrocaneal bursitis, calcaneal stress fracture, posterior ankle impingement, and Achilles tendinopathy. The diagnosis can usually be made on the basis of the history and a thorough physical examination, but in some cases (e.g., stress fracture) imaging studies are indicated. Treatment is nearly always conservative. Patients should be referred to an orthopaedic surgeon if symptoms are persistent.

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Copyright information

© Bohn, Stafleu van Loghum 2012

Authors and Affiliations

  • J. I. Wiegerinck
    • 1
  • P. A. Struijs
    • 1
  • B. Oudhof
    • 2
  • H. C. P. M. van Weert
    • 3
  1. 1.afdeling OrthopedieAMCAmsterdamThe Netherlands
  2. 2.afdeling HuisartsgeneeskundeAMCAmsterdamThe Netherlands
  3. 3.hoogleraar HuisartsgeneeskundeAmsterdamThe Netherlands

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