Virginia Via Research Day Book 2026

Medical Student Research Case Reports

18 CONSERVATIVE MANAGEMENT OF A UNICAMERAL INTRAOSSEOUS CALCANEAL CYST IN A COLLEGE DISTANCE RUNNER

Priyanka Avasarala, OMS-III; Kyle Hopkins, DO; Zander Lichosik, MAT, LAT, ATC; Destini Kruse, MS, LAT, ATC, CES; Greg Beato, DO, CAQ, FACOI; Mary Mitchel, DO, CAQSM Corresponding author: pavasarala@vcom.edu

25 Beamer Way, Blacksburg, VA 24061

uncommon finding, further evaluation with MRI was prompted and demonstrated a unicameral intraosseous cyst of the right calcaneus. Comments: Intraosseous cysts of the calcaneus are rare findings in athletes presenting with heel pain. The lesions are often incidental findings but can occasionally contribute to exercise-induced pain or functional limitations. The spectrum of treatment pathways is debated, but often depends based on degree of symptoms. If unable to achieve symptom relief conservatively, then surgical intervention with curettage and bone grafting for larger lesions can be considered. Size of the lesion and symptoms are important considerations; however, the primary consideration is the malignant potential of these lesions is not properly evaluated. Thus, advanced imaging is often necessary to rule out more aggressive pathology compared to more benign stress-related injuries and to determine best prognostic and sport-specific recommendations. [KH4.1]

Context: Unusual findings in medicine are often not uncommon. In our case, an intraosseous cyst was identified in a collegiate athlete with vague heel pain. Report of Case: In this report, an 18-year-old male collegiate distance runner presented with a two-week history of intermittent right medial calcaneal pain that began during a medium-distance run. Symptoms were not alleviated with over-the-counter medications or with a decrease in mileage and intensity. Gentle rehab modalities with ATC staff were not providing any notable benefits. He has maintained regular upkeep of his footwear. Very mild tenderness at the medial body of the calcaneus. No tenderness of the lateral or plantar calcaneus, navicular, cuboid, cuneiforms, base of the 5th metatarsal, 1st metatarsal. On osteopathic exam, he had an anterior talus. Negative anterior ankle drawer, tuning fork, and hop tests. Passive ROM in all planes and with resistance were symmetrical bilaterally. No obvious antalgic, Trendelenburg or pes planus dysfunctions on gait visualization. Weight-bearing radiographs were obtained due to the vague nature of his symptoms and revealed a possible intraosseous lipoma. Due to this

Diagnosis: Unicameral intraosseous calcaneal cyst Treatment: Initial management of our athlete included rest, brief activity modification, intrinsic foot strengthening and a two-week course of Meloxicam 15 mg daily. At two-week follow-up, the athlete reported complete resolution of pain and had resumed full running, including distance and speed training without limitation [KH6.1]. If conservative management stagnates or fails in the future, we will refer to orthopedics. Conclusion: This case illustrates that a unicameral intraosseous calcaneal cyst can present with activity related heel pain in endurance athletes and may respond favorably to conservative management, including temporary activity modification and anti-inflammatory therapy. Early imaging in the right patient can aid in diagnosis and reassurance, while ongoing monitoring ensures safe return to sport without recurrence.

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