Monostotic fibrous dysplasia of calcaneus.

Abstract

This report presents a case of fibrous dysplasia (FD) of the calcaneus in a patient in her 20s who initially experienced swelling followed by pain in her heel during weight-bearing activities. She visited multiple local clinics, leading to ineffective treatments.Upon presentation to a tertiary care hospital, a thorough clinical examination and radiological imaging (radiographs and CT scan) revealed a well-circumscribed, ground-glass appearance in the calcaneus, consistent with FD. Histopathological examination confirmed the diagnosis, showing curvilinear trabeculae of woven bone arranged in a Chinese letter pattern, surrounded by a fibroblastic stroma.The patient underwent surgical management, which included excisional biopsy, extended curettage and bone grafting using ipsilateral iliac crest bone mixed with beta-tricalcium phosphate. Postoperative immobilisation was managed with a below-knee cast for 6 weeks, and follow-up radiographs showed successful graft consolidation without any cortical breach.This case highlights the importance of accurate diagnosis, the potential for misdiagnosis in cases of FD, especially when seen at unusual locations, and the effectiveness of curettage and bone grafting for large bone defects. Early recognition through appropriate clinical evaluation and radiological imaging can prevent delays in treatment and lead to better outcomes.