Ultrasonography Can Be Early Diagnostic Modality for Pediatric Calcaneus Fractures: A Case Report

Although calcaneus fractures may be the most common pediatric tarsal bone fracture, most occult calcaneus fractures are not visible on plain radiography, resulting in delayed diagnosis. However, ultrasonography can aid early diagnosis of this fracture with an unspecified mechanism of injury and unremarkable radiographic findings. In a pediatric patient with progressive ankle swelling and pain, initial plain radiography was unremarkable, and antibiotics were administered for suspected infective arthritis. After limping developed, ultrasonography showed symmetric growth plates of bilateral distal tibia, fibula, and tarsal bone; a step-off calcaneus cortex with periosteal reaction; increased power Doppler flow; and probe tenderness, indicating a fractured calcaneus. This case shows the value of ultrasonography and supports this modality as a promising alternative for early diagnosis of pediatric calcaneus fracture.