Answer for BIR CoW 24 May 2026
Bilateral intraarticular calcaneal fracture (Lover's fracture)
Findings
X ray bilateral lateral view of ankle shows Bilateral calcaneal fractures are noted involving the body of the calcanei. Fracture lines appear intra-articular with disruption of the posterior subtalar articular facets on the left side. Fracture line appears extraarticular on the right side. Cortical break noted in right navicular bone. Surrounding soft tissue swelling is present around both heels. Alignment at the ankle joints is maintained. No obvious associated distal tibial or fibular fracture identified. Impression: Left intra-articular calcaneal fracture (“Lover’s fracture”). Right extra-articular calcaneal fracture with associated fracture in right navicular bone.
Discussion
A "lover's fracture" (also known as a Don Juan or Casanova fracture) is a colloquial term for a fracture of the calcaneus (heel bone) caused by a high-impact fall or jump onto the heels. CT of calcaneal fracture: Sanders Classification is Frequently used to classify intra-articular fractures based on the number of articular fragments seen on coronal and axial CT views. MRI of Calcaneal fracture: On MRI, a lover's fracture will typically show extensive bone marrow edema, appearing bright on fluid-sensitive sequences (such as T2-weighted or STIR) and dark on T1-weighted images. This reveals the "bone bruise" or micro-trabecular fractures around the heel bone.
Findings
X ray bilateral lateral view of ankle shows Bilateral calcaneal fractures are noted involving the body of the calcanei. Fracture lines appear intra-articular with disruption of the posterior subtalar articular facets on the left side. Fracture line appears extraarticular on the right side. Cortical break noted in right navicular bone. Surrounding soft tissue swelling is present around both heels. Alignment at the ankle joints is maintained. No obvious associated distal tibial or fibular fracture identified. Impression: Left intra-articular calcaneal fracture (“Lover’s fracture”). Right extra-articular calcaneal fracture with associated fracture in right navicular bone.
Discussion
A "lover's fracture" (also known as a Don Juan or Casanova fracture) is a colloquial term for a fracture of the calcaneus (heel bone) caused by a high-impact fall or jump onto the heels. CT of calcaneal fracture: Sanders Classification is Frequently used to classify intra-articular fractures based on the number of articular fragments seen on coronal and axial CT views. MRI of Calcaneal fracture: On MRI, a lover's fracture will typically show extensive bone marrow edema, appearing bright on fluid-sensitive sequences (such as T2-weighted or STIR) and dark on T1-weighted images. This reveals the "bone bruise" or micro-trabecular fractures around the heel bone.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!