LAUSR

A previously healthy 10yearold boy presented with a 2month history of pain and marked nonreducible plantar flexion of the right foot. Symptoms occurred after a mild injury to his right foot and progressively had increased during the last month, persisting all day long, and worsening with movements, limiting daily activities including school attendance. Prolonged bed rest, and treatment with different types of nonsteroidal antiinflammatory drugs was ineffective. A similar, but milder and transient episode had occurred a year earlier. His family history was unremarkable. On physical examination the patient presented in good general health. His right foot was in a fixed posture, with nonreducible plantar flexion of ankle and toes (Figure 1A). Mild swelling was palpable on the dorsal area of the foot with preserved skin color. His ankle joint mobility was completely restricted, and the boy was unable to bear weight on the affected side. Extreme sensitivity to light touch was appreciable, and pain assessment by visual analog scale was referred by the child to be 8 out of 10.