{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T18:48:52Z","timestamp":1793558932800,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Calcaneal apophysitis (Sever's disease) is an overuse condition caused by repetitive traction stress to the calcaneal apophysis. Whether Achilles tendon morphology is altered in this young patient population remains unknown. Therefore, we aimed to identify differences in Achilles tendon morphology between youth athletes diagnosed with calcaneal apophysitis and healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective chart review included 46 patients (n\u2009=\u200923 Sever's disease, 15F\/8M, 12.4\u2009\u00b1\u20092.3\u2009years old) and (n\u2009=\u200923 healthy controls, 13F\/10M, 15.9\u2009\u00b1\u20091.5\u2009years old) who sought care in a Children's Hospital Sports Medicine\/Orthopedics Department between 2012 and 2022. We measured ultrasound\u2010derived degree of tendon thickening, Achilles tendon thickness (cm), and cross\u2010sectional area (CSA [cm<jats:sup>2<\/jats:sup>]). Separate multivariate analyses of covariance (MANCOVAs) were used to compare degree of thickening, mass\u2010normalized Achilles tendon thickness, and CSA between participant groups, covarying for age. Cohen's <jats:italic>d<\/jats:italic> effect sizes were used to assess the magnitude of mean differences and standard error (MDSE) between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Young athletes with Sever's disease had a significantly greater degree of tendon thickening with a large effect compared with healthy controls (MDSE: 0.07 [0.01]\u2009mm <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, <jats:italic>d<\/jats:italic>\u2009=\u20091.39). Achilles tendon thickness and CSA did not statistically differ between groups; however, the magnitude of between\u2010group differences for these measures (MDSE: 0.18 [0.05]\u2009cm, MDSE: 0.27 [0.07]\u2009cm<jats:sup>2<\/jats:sup>, respectively) were moderate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings demonstrate previously unrecognized differences in Achilles tendon morphology between young athletes with clinically diagnosed Sever's disease and healthy controls. Our study supports incorporating diagnostic ultrasound as part of a comprehensive examination to ensure appropriate diagnosis and clinical management for adolescents with heel pain.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16454","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T13:04:15Z","timestamp":1711371855000},"page":"1303-1312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Youth Athletes With Sever's Disease Exhibit Altered Achilles Tendon Ultrasound Characteristics"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5866-9853","authenticated-orcid":false,"given":"Shawn L.","family":"Hanlon","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin E.","family":"Whitney","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedics Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5702-9184","authenticated-orcid":false,"given":"Alexandra F.","family":"DeJong Lempke","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedics Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Department of Physical Medicine &amp; Rehabilitation Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-013-2219-9"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198701000-00007"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(20)30480-4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-199907001-00008"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TME.0000000000000219"},{"key":"e_1_2_7_7_1","first-page":"1995","article-title":"Sever's disease and other causes of heel pain in adolescents","volume":"54","author":"Madden C","year":"1996","journal-title":"Am Fam Physician"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38197"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-009-0774-y"},{"key":"e_1_2_7_10_1","first-page":"1025","article-title":"Apophysitis of the os calcis","volume":"95","author":"Sever J","year":"1912","journal-title":"N Y Med J"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.7547\/0980212"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/oajsm.s15413"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2008.07.004"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001145"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-199418030-00004"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042752-200301000-00003"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.12-225599"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12631"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2008.054239"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/S-2006-924590"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/sports7120245"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2020.8796"},{"key":"e_1_2_7_23_1","first-page":"801","article-title":"Ultrasonography of the calcaneus in Sever's disease","volume":"42","author":"Hosg\u00f6ren B","year":"2005","journal-title":"Indian Pediatr"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.11138\/mltj\/2017.7.1.192"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.16105"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.16603\/ijspt20171134"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.2020.1847004"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-16996-w"},{"key":"e_1_2_7_29_1","unstructured":"SmialekD.Omni Calculator.https:\/\/www.omnicalculator.com\/health\/."},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e31818cb278"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2010.01051.x"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7580.2011.01461.x"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.2478\/hukin-2021-0003"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2009.00986.x"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40798-015-0009-9"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002459"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00012.2018"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.2022.2113987"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00671"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-015-0438-0"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12318"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.16454","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T10:20:10Z","timestamp":1721989210000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.16454"}},"subtitle":["A Retrospective Case\u2013Control Study"],"short-title":[],"issued":{"date-parts":[[2024,3,25]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1002\/jum.16454"],"URL":"https:\/\/doi.org\/10.1002\/jum.16454","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,25]]},"assertion":[{"value":"2023-09-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}