Our young son has developed heel pain the physician thinks is something called Sever disease or syndrome. I read the Patient Guide to Sever’s Syndrome on your website. You say that X-rays aren’t that helpful in diagnosing Sever’s syndrome. The physician we are seeing is insisting on ordering X-rays. We would like to limit exposure to X-rays. Can we decline?

You can always decline any medical testing and/or treatment but it may not be in the best interest of the patient. In the case of Sever syndrome or disease, we mention in our Patient’s Guide to Sever’s Syndrome that physicians may order X-rays in order to make sure there isn’t something more serious going on.

The X-ray may appear to show small cracks within the bone at the back of the heel. The cracks are the bone growth center and are normal. However, even kids who have no pain at all may seem to have these cracks on X-rays.

The surgeon is looking for any lesions that require additional treatment. More serious problems such as true bone fractures, fibromas (or other tumors), or cysts could be present along with the Sever disease. Any abnormal radiographic findings will likely be followed up with MRIs in order to determine the best treatment approach possible for the problem(s) identified.

Let your surgeon or other physicians know of your desire to minimize the child’s exposure to radiation. They will be able to guide you through this process balancing the need to minimize costs, reduce radiation exposure, yet find out what’s wrong and plan treatment accordingly.