Sever's disease: what does the literature really tell us?

BACKGROUND Sever's disease is typical of many musculoskeletal conditions where observational annotations have slowly been accepted as fact with the passing of years. Acceptance of these nontested observations means that health professionals seeking information on this condition access very low-level evidence, mainly being respectable opinion or poorly conducted retrospective case series. METHODS A comprehensive review of the literature was undertaken gathering available articles and book references relating to Sever's disease. This information was then reviewed to present what is actually known about this condition. RESULTS Respectable opinion and poorly conducted retrospective case series make up the majority of evidence on this condition. CONCLUSION The level of evidence for most of what we purport to know about Sever's disease is at such a level that prospective, well-designed studies are a necessity to allow any confidence in describing this condition and its treatment.