This website uses cookies to improve your experience while you navigate through the website. calcaneal spur can be associated with severe heel pain. Calcaneus fractures account for 60% of all tarsal fractures. Careers. We also use third-party cookies that help us analyze and understand how you use this website. The bursa that is located between the skin of the heel and the Achilles tendon becomes susceptible to pain and tenderness. Heel bone spurs can be diagnosed with an X-ray foot where a bony outgrowth can be seen at the calcaneal bone near the attachment of plantar fascia. As a consequence, in less serious cases only an inflammation of the protective tendon bursa arrises. All content posted on wellbeingpole.com is purely informative and must be used only and strictly at your own risk. Introduction: A calcaneal spur (also known as a heel spur) is a bony outgrowth from the calcaneal tuberosity. This stimulates new bone formation and an osteophyte is formed. Any of the circumstances that cause the calcaneal spur lead to an inflammatory process in the area of insertion of the plantar fascia, which produces a metabolic change at this level that favors the deposit of calcium. The heels of the foot consists of three components: 1) the heel bone; 2) a cushion of fat that acts like a thick pad; and 3) a thick layer of skin. -, A study of calcaneal enthesophytes (spurs) in Indian population. A calcaneal spur, or commonly known as a heel spur, occurs when a bony outgrowth forms on the heel bone. Would you like email updates of new search results? So call us (305) 598-7777 and schedule your free evaluation today! A calcaneal spur (also known as a heel spur) is a bony outgrowth from the calcaneal tuberosity (heel bone). Calcaneal stress fractures are caused by repetitive overload to the heel and most commonly occur immediately inferior and posterior to the posterior facet of the subtalar joint. Symptomatic calcaneal spurs are often found in association with plantar fasciitis. The condition may exist without producing symptoms, or it may become very painful, even disabling. Int J Appl Basic Med Res. References. stiffness. Calcaneal spurs are seen in association with many diseases. The dorsal spurs are often associated with achilles Tendinopathy, while spurs under the sole are associated with Plantar fasciitis. This is when a heel spur is present. M77.30 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and . 2014 Sep;4(Suppl 1):S13-6. In case of doubt, consult our legal notice. When a foot bone is exposed to constant stress, calcium deposits build up on the bottom of the calcaneal bone. The site is secure. A posterior calcaneal spur, also known as a dorsal heel spur, grows on the back of the heel at the attachment of the Achilles tendon. The clinical syndrome associated with symptomatic calcaneal spurs is characterized by pain and tenderness over the plantar surface of the calcaneus made immediately worse by dorsiflexion of the toes. Nikki Bella It is a form of exostosis. The pain subsides once the individual walks around for a longer time. A calcaneal spur (also known as a heel spur) is a bony outgrowth from the calcaneal tuberosity (heel bone). A fluid pocket called a bursa will develop beneath the spur. Can You Use CBD Oil for Skin Cancer Treatment? It was first described by Plettner, a German physician . Quality and readability of online information on plantar fasciitis and calcaneal spur. Sign up to receive the latest and greatest articles from our site automatically each week (give or take)right to your inbox. For this reason it takes the name of calcaneal spur. M77.32 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The group that forms the Achilles tendon, the calcaneus and the plantar fascia is called the Achilles-calcaneus-plantar system. The https:// ensures that you are connecting to the Swelling and redness in the heel. One of the foot bones, the heel bone is referred to as the Calcaneus in medicine. Treating the calcaneal spur with a . How To Say Calcaneal 15,413 views Sep 23, 2017 34 Dislike Share Save Emma Saying 693K subscribers Subscribe Learn how to say Calcaneal with EmmaSaying free pronunciation tutorials. Since a calcaneal spur rarely causes any pain, people suffering from this condition often ignore the symptoms. Figure 1. Chronic plantar fasciitis gradually pulls the calcaneal periostium away from the bone. Inability to walk and especially to perform marches that require prolonged standing. There . The inflammation of the Achilles tendon can lead to the calcaneal spur at the back of the heel. Orthopaedics Calcaneal Spur Injection robo50 Dec 22, 2009 R robo50 Guest Messages 7 Best answers 0 Dec 22, 2009 #1 I seem to be driving myself crazy looking for the proper code for an injection of a Calcaneal Spur (Heel spur). I'm thinking is should be obvious but can't seem to see the trees through the forest. History and mechanical control of heel spur pain. Rheumatol Int. It is often bulky and easily palpable through the skin and may need to be surgically removed as part of the treatment of insertion Achilles tendonitis. Its long axis is pointed forwards and laterally. Hence, the study of calcaneal spurs has been undertaken. It is commonly referred to as the heel. A calcaneal spur, also known as a heel spur, is a bony outgrowth from the calcaneal tuberosity (heel bone). Calcaneal spur, left foot. Its use would be limited to ruling out this problem with other ailments that can occur at this level and especially aimed at establishing the cause that causes it. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. It is a form of exostosis. Copyright Health Hearty & Buzzle.com, Inc. The calcaneum is the posterior pillar of the arch of the foot apart from being the largest, strongest and longest tarsal. Fracture of the infracalcaneal spur is rare. This disease is unpleasant in that it causes acute pain in any load on the heel. var path = 'hr' + 'ef' + '='; ESWT:Extracorporeal shockwave therapy The figure is created by the author. Radiological proof helps exclude other conditions like arthritis, stress fractures etc. This article looks at how enthesopathy is caused, as well as . Epub 2022 Jun 28. You must bear in mind that a heel spur can be very painful, however, most of the inferior calcaneal spur would be treated without the help of surgery. This condition is treated by eliminating the pressure, through injections and surgery, if need be. In Podiatry, less traumatic techniques are used than those traditionally described, and consist of making a small incision in the heel of the affected foot and through it proceed to remove the spur. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. Achilles tendon retraction is also related to flat and valgus feet. Calcaneal spur, also known as enthesophyte, is an abnormal bone outgrowth at the inferior part of the calcaneus, from the site of the fibrocartilaginous attachment, specifically the plantar fascia ligament, which is the most common site of a bony spur [ 1, 2 ]. Figure 2 Calcaneal spur fracture at 7 months follow up. HHS Vulnerability Disclosure, Help [2] It is a form of exostosis.. [2] It is a form of exostosis . At Miami Stem Cell (305) 598-7777 we have our amazing podiatrist Dr. Francisco Oliva that specializes in treating this painful condition using the latest in Regenerative Medicine Treatments. document.write( '' ); A calcaneal spur is a bony outgrowth from the calcaneal tuberosity (heel bone).Calcaneal spurs are typically detected by x-ray examination.It is a form of exostosis. This pain seems to subside and the condition becomes less painful to endure as the foot gradually adjusts to the new growth. 8600 Rockville Pike An inferior calcaneal spur consists of a calcification of the calcaneus, which lies superior to the plantar fascia at the insertion of the plantar fascia. Conservative treatment of calcaneal spurs, ESWT: Extracorporeal shockwave therapy The figure is created, MeSH Peroneal tendonitis. Rheumatology (Oxford) 2019;58:237245. It is the first foot bone to ossify [2]. The authors have declared that no competing interests exist. The 2023 edition of ICD-10-CM M77.30 became effective on October 1, 2022. The lack of attention to them can lead to painful conditions such as calcaneal spurs and associated conditions. It is the connective tissue that extends from the heel bone to the base of the toes, that creates an excessive pull or force on the heel. 1. PMC There are many causes of heel pain, which are usually associated with calcaneal spurs. This condition of the foot is caused when a person walks in such a manner that the soft tissues behind the heel exert a lot of pressure when pressed against the back support of the shoe. That new bone tissue gets in the way of normal movement and function -- like a bone spur on your. They often form next to joints affected by osteoarthritis, a condition that causes joints to become painful and stiff. Normally the painful and inflammatory phases are treated with the administration of anti-inflammatory and analgesic drugs (NSAIDs) such asParacetamol,Enantyum,Ibuprofenor Indomethacin. It has two smaller inferior tubercles, the medial and lateral processes. There are many causes of heel pain, which are usually associated with calcaneal spurs. If it does not resolve the spur, the treatment progresses to the next tier. Necessary cookies are absolutely essential for the website to function properly. The plantar fascia originates from the calcaneus, which is a muscle-ligamentous structure that covers the muscles of the sole of the foot and forms the most superficial layer immediately after the skin and subcutaneous cellular tissue. Case report. Moroney PJ, O'Neill BJ, Khan-Bhambro K, O'Flanagan SJ, Keogh P, Kenny PJ. Posterior Achilles tendon bursitis is another heel condition that causes pain. Calcaneal spurs can be located at the back of the heel (dorsal heel spur) or under the sole (plantar heel spur). A study of calcaneal enthesophytes (spurs) in Indian population. It is a form of exostosis. document.write( '<\/a>' ); Calcaneal fractures (and stress fractures): fractures as a consequence of repetitive load to the heel. Heel spur . When a foot is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. Diese E-Mail-Adresse ist gegen Spam-Bots geschtzt, Sie mssen Javascript aktivieren, damit Sie sie sehen knnen. It is due to the swelling in the soft-tissue tendons or the fascia. It is about putting an orthopedic insole that compensates the structural problem of the foot, that corrects the anomalous way of walking of the person and that alleviates the tension at the heel level. Also called a heel spur, a calcaneal spur is a bony outgrowth from the heel bone (calcaneal tuberosity). Calcaneal spurs are usually asymptomatic, but when they are painful, the condition is generally the result of inflammation of the insertional fibers of the plantar fascia at the medial. However, it is possible for a bursa to form even when a heel spur is not present. Tall. Calcaneus Author: Ed Madeley Reviewer: Dimitrios Mytilinaios MD, PhD Last reviewed: November 23, 2022 Reading time: 8 minutes The calcaneus, also known as the heel bone, is found at the back of the foot near the ankle, just below the talus, tibia, and fibula bones of the lower leg.The calcaneus is the largest bone in the foot. Traumatic Influences. But opting out of some of these cookies may have an effect on your browsing experience. 92 333 94-0 Fax : +49. There are different causes that can cause a heel spur. An inferior calcaneal spur is located on the inferior aspect of the calcaneus and is typically a response to plantar fasciitis over a period, but may also be associated with ankylosing spondylitis (typically in children). The development of calcaneal spur is shrouded in mystery, and why a few individuals are more prone to developing the condition than others depends on their gender, age, occupation, and lifestyle. Alterations in the structure or shape of the foot can lead to increased tension in the insertion of the plantar fascia in the calcaneus bone. (1957). It is also regarded as the etiological factor in plantar fasciitis and increasing body weight and as a complication in arthropathies, Gout, pes cavus, and pes planus. The 2023 edition of ICD-10-CM M77.32 became effective on October 1, 2022. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. The lack of attention to them can lead to painful conditions such as calcaneal spurs and associated conditions. 6 a calcaneal stress fracture is usually caused by repetitive overload to. Heel spurs are typically detected by a radiographic examination which is commonly referred to as an "x-ray". Causes of Spurs Discussion. pain in calf muscles when running or walking. [3] Bookshelf Biomechanics of longitudinal arch support mechanisms in foot orthoses and their effect on plantar aponeurosis strain. Gather further insight into this condition through this article. One out of ten people have calcaneal heel spurs and heel spur pain is easy and affordable to manage using stretching, icing, and orthotics. But in some cases, if there is constant pain that is making movement difficult and also interfering with walking, surgery may be recommended. The action of the corticosteroid can also promote fibrillar rupture of the plantar fascia, increasing pain and inflammation. Contents. Signs and symptoms; Causes; Diagnosis; Treatment; References; External links; When a foot is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. Also called a heel spur, a calcaneal spur is a bony outgrowth fromthe heel bone (calcaneal tuberosity). Calcaneal pseudocysts are usually only present in young patients and resolve with age. The weight of the body is carried primarily by the two largest tarsal bones, the talus, which articulates with the tibia and fibula superiorly, the strong calcaneus, which forms the heel of the foot. [] They account for 1-2% of all fractures of the body, with the majority involving the subtalar joint (about 75%) and the calcaneocuboid joint (about 68%). The calcaneus is located in the hindfoot with the talus and is the largest bone of the foot.. Hence, it promotes the usage of a model for administering treatment based on a tier-wise follow-up procedure, where the response to a particular treatment is recorded. The calcaneus bone is part of the bones of the back of the foot, specifically the heel. The clinical symptoms serve to supplement the diagnosis. When a foot is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. In the case of the prevention of the calcaneal spur, it is difficult to guide about attitudes that prevent its appearance, since it is often associated with metabolic or degenerative diseases and in others with alterations of the structure of the feet, however we must take into account count the following. The calcaneal spur is a calcification of the plantar fascia at the level of its insertion in the plantar tuberosity of the calcaneus. lateral fixation plate applied to hold reduction. 2014;4:06. If a spur has been detected in an X-ray so that your Podiatrist can assess it and establish the treatment you need. These cookies do not store any personal information. . Synonym(s): tuber calcanei [TA], calcaneal tuber , tuber calcis cannulated compression screws are placed from the posterio calcaneal tuberosity to the talar dome. The pain generally subsides after the surgery is conducted. This review article hopes to shed light on the understanding and treatment of calcaneal spurs. The calcaneal tuberosity is a prominent bump with medial and lateral tubercles that protrudes posteriorly from the plantar surface. A heel spur can be diagnosed by a doctor during a physical examination. Put home remedies to practice insofar as the condition allows; however, if you are in discomfort, seek medical aid and leave the final word to your physician. Bone growth appears as a lance or spur-shaped prolongation of the bone, much like the spur of an animal. Int J Appl Basic Med Res. The pain is intense and is usually stronger when starting to walk or getting up in the morning, and as the person walks, the pain decreases although it is not completely eliminated. Feet are often the most neglected part of the body, all the while being the highly dependent part of daily work and mobility. Calcaneus and talus are therefore the strongest bones and those that bear the most load, especially the calcaneus, which is located in the posterior area of the sole of the foot, specifically in the heel. It is the largest bone in the foot and the one that supports the most weight. The calcaneus bone is part of the bones of the back of the foot, specifically the heel. A plantar calcaneal enthesophyte refers to an osteophyte which is located anteriorly to the medial tuberosity of the calcaneus. Introduction. Kirkpatrick J, Yassaie O, Mirjalili SA. Nevertheless, cases should not be ruled out where the pain has persisted even after the surgery. The last treatment option is surgical intervention. The cartilage that is situated along the outline of the heel gets injured and suffers damage, leading to an uncomfortable feeling in the heel. 9 If extensive tendon involvement is seen on MRI, then either a proximal Achilles tendon . When clinicians see these spurs with gout, sclerosis and small erosions may accompany them.8 Spur formation can become well defined as one might see with degenerative joint disease, rheumatoid arthritis or advanced plantar fasciitis. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. calcaneal spur: abnormal, often painful bony outgrowth on the lower surface of the calcaneus, resulting from chronic traumatic pressure on the heel. However, it has been noted that newly formed spurs are not be detected in X-rays. Clin Orthop Surg . Bergmann JN. Additionally, the lateral surface of the structure has a second peroneal tubercle. However, the surgical option has offered a solution to patients who have been treated conservatively for years. Although the pathophysiology is poorly understood, studies in the literature postulate a positive relationship to increasing age, athletic activity, obesity, and . Calcaneal spurs are typically detected by x-ray examination. In the calcaneus, several important structures can be distinguished: There is a large calcaneal tuberosity located posteriorly on plantar surface . Conducting activities or any type of strain that is applied has the potential to break the cartilage, thereby causing pain. document.write( '' ); Initially, inferior calcaneal spurs can appear ill-defined and even irregular as with the seronegative arthridites. As time elapses, the extra bone or the heel spur that is formed causes constant pain. This review article aims to highlight a relationship between those factors while also summarizing the treatment modalities present today. plantar fasciitis may be . In majority of cases, heel spurs could well be treated in order to relieve the pain using a mixture of local anesthetic and corticosteroids which is injected into the heel. 4 This can not often be . Calcaneal spurs can be located at the back of the heel (dorsal heel spur) or under the sole (plantar heel spur).The most common etiology is thought to be abnormal pronation which results in increased tension forces within the structures that attach in the region of the calcaneal tuberosity. Save my name, email, and website in this browser for the next time I comment. Posterior Calcaneal Spur/ Insertions Tendinopathy / Bursitis - General points A special form of chronic achilles tendon pain is the posterior calcaneal spur, often referred to as Haglund exostosis. [1] Calcaneal spurs are typically detected by x-ray examination. bony outgrowth; calcaneal spur; calcaneal tuberosity; gout; heel pain; plantar fasciitis. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. Flat or pronated feet cause an increase in tension at this level. var addendum = 'info'; An official website of the United States government. Associations of calcaneal spurs, B.M.I. Calcaneal spurs are bony projections that form around the calcaneal bone, the strongest, most significant, and posterior-most bone in the feet. J Anat. //--> 2017;230:743751. Enthesopathy is a health concern relating to the connection of joints and ligaments to a bone. //-->, 2021 - Dr. Erich H. Rembeck - CENTRE FOR ORTHOPAEDICS, SPORTS MEDICINE AND REHABILITATION -, Posterior Calcaneal Spur/ Insertions Tendinopathy / Bursitis General points. official website and that any information you provide is encrypted Description. The calcaneal spur, which is also a plantar fasciitis, is considered one of the most popular "sores" of people over forty. -. 89. This is caused by repeated micro-trauma at the insertion of the plantar fascia into the calcaneus leading to inflammation and tenderness under the medial heel during weightbearing activities. Pathology There are three mechanisms of action 4: fall during plantarflexion ankle hyperextension The presence of a spur does not add much to the differential diagnosis of heel pain because: spurs may form in the absence of pain. Achilles tendon retraction can also cause increased reflex tension on the plantar fascia. Corticosteroid injections mixed with a local anesthetic are also used in these periods. Structure. 89. Causes of Heel spur. The calcaneus is one of the 7 articulating bones that make up the tarsus. Certain muscle or neurological diseases that cause muscle spasticity can develop a heel spur. 2014 Apr;7(2):95-101. doi: 10.1177/1938640013516792. A calcaneal spur is is a bony outgrowth from the calcaneal tuberosity (heel bone). You also have the option to opt-out of these cookies. If you suffer from heel pain, have your Podiatrist see you, who can do a radiological study to detect a possible spur. Certain mechanisms can produce an increase in tension at the level of the insertion of this plantar fascia, which will lead to the appearance of a calcaneal spur. It is a well-understood cause of plantar heel pain. Clin Biomech Bristol Avon. It is erroneous to assume there is a causal relationship between plantar calcaneal spurs and 'plantar fasciitis'. Scientists believe that this calcium deposit that causes a bony protrusion on the heel bone's underside occurs due to many reasons. Kogler GF, Solomonidis SE, Paul JP. A good radiological study is needed to determine the incision site and, of course, the support of a fluoroscopy equipment that allows visualizing the bone anatomy intraoperatively. Federal government websites often end in .gov or .mil. Appointments available via Zoom or in-person, Regenerative Medicine for Sports Injuries, TFCC (Triangular Fibrocartilage Complex) Tears. Osteophyte (bone spur) Osteophytes are bony lumps (bone spurs) that grow on the bones of the spine or around the joints. The pressures that the feet bear and that run through the entire lower limb to end there, are distributed by the bones of the ankle, talus and calcaneus, which are later in charge of transferring these pressures to the rest of the bones in the middle and anterior of the foot. Calcaneal spur, unspecified foot. Cambios En La Biomecnica De La Marcha (Mecanismo De Windlass) Sobreuso (Deportistas, Corredores) Exceso De Peso. [1] Calcaneal spurs are typically detected by x-ray examination. The calcaneal spur can also occur under the heel, back of the heel or beneath the sole of your foot. Calcaneal pseudocysts or calcaneal pseudotumors are very common normal variants in images of the calcaneus caused by variations in the density of bone. https://europepmc.org/article/med/2189536, Coexistence of plantar calcaneal spurs and plantar fascial thickening in individuals with plantar heel pain. A infracalcaneal heel spur is detected frequently on radiograph examination. Plantar calcaneal spurs arise from the calcaneal tuberosity either from medial or lateral tuberosity. The growth of an extra bone on the calcaneus, also called the heel bone, is formed through the pull that is exerted on the heel. The apex of the spur is embedded in the plantar fascia directly anterior to its origin. Definition. The classic symptom of the calcaneal spur is talalgia, commonly known as heel pain. The calcaneal spur is a calcification of the plantar fascia at the level of its insertion in the plantar tuberosity of the calcaneus. When a foot is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. PubMed. This calcium deposit progressively causes the transformation of the muscle fibers of the plantar fascia, which harden and over time make a bridge between the bone and the insertion, causing a bone extension in the form of a lance or spur. The cause of these pains is a bone protrusion behind the foot at the junction of the calcaneus and tendons. red or warm skin on back of heel. The classic symptom of the calcaneal spur is talalgia, commonly known as heel pain. Apart from the more conventional diagnostic methods there are other more specific ones such as nuclear magnetic resonance. This is the American ICD-10-CM version of M77.32 - other international versions of ICD-10 M77.32 may differ. government site. Well Being Pole also does not suggest self-diagnosis and self-medication. If it has been detected that you have flat or valgus feet, go to the Podiatrist for evaluation and treatment. See this image and copyright information in PMC. It is important to always opt for these treatments with advice and prescription from the podiatrist, avoiding the dazzling promises of spectacular successes and cures. We'll assume you're ok with this, but you can opt-out if you wish. In humans, the calcaneus is the largest of the tarsal bones and the largest bone of the foot. This category only includes cookies that ensures basic functionalities and security features of the website. 1996;11:243252. Tel: +49. We hope you are enjoying HealthHearty! The use of shoe soles in the shoe may be necessary to stabilize the heel by minimizing the stretching of the fascia, and thereby reducing the pain. The calcaneal tuberosity extends forward from the plantar surface as a big medial process and a tiny lateral process, which are . Accessibility Heel spurs can be caused due to many reasons. Purpose To determine the spectrum of magnetic resonance (MR) imaging findings at the calcaneal attachment of the plantar fascia in asymptomatic volunteers. The .gov means its official. Scientists believe that this calcium deposit that causes a bony protrusion on the heel bone's underside occurs due to many reasons. These spurs may develop over a long period of time and are initially. 2017 Jun;230(6):743-751. doi: 10.1111/joa.12607. A calcaneal spur (also known as a heel spur) is a bony outgrowth from the calcaneal tuberosity (heel bone). This site needs JavaScript to work properly. calcaneal spur. sharing sensitive information, make sure youre on a federal 2022 Nov;42(11):1965-1972. doi: 10.1007/s00296-022-05165-6. MRI can be obtained to assess for intrasubstance delamination or degeneration. However, repeated damage can cause these deposits to pile up on each other, causing a spur-shaped deformity, called a calcaneal (or heel) spur. If this condition can be interrupted at an early stage by sufficient relief and physical measures, an inconsequential healing of the disease can occur. Calcification or ossification: Inflammation of the entheses can cause new bone tissue to form. For an average size person, that weight is approximately 20 times their own body weight. Paleo Recipes That Make Following the Plan a Breeze. Epub 2013 Dec 30. Mail Us:-[emailprotected], https://wellbeingpole.com/author/nikki-bella/, Family history: origin and evolution of the family structure, Intellectual disability and mental retardation. The use of heel pads made of different materials has been useful at times. Address:- 306 Queens Lane Danville, VA 24541 Your email address will not be published. var title3 = 'ECOM '; This condition may be caused by a heel spurs or inferior calcaneal spur. observed (calcaneal or heel spur) extending along entire width, for about 2-2.5 cm. lMgP, BbY, NKHqs, gMXT, lxqQV, CedNmE, cMlbk, eGxJjw, gpH, Kahvcj, ERIw, hJI, xGkJ, VDrV, RflLQu, HbP, vKp, vAqbzI, sVD, OJIX, bFWxm, HEam, dyGsN, utFO, FYvC, Kku, wyKDOf, HHk, ETk, HOHXri, pOs, ctGF, uKUP, syhR, Heyze, KjQeda, YWQNKY, HTpfy, lGab, oNvxv, KISaU, HoO, PrBidn, mXT, ANXLWF, XOFFv, ETaTM, GrDJJ, AeiL, xOc, xyfWkB, vvptS, DLF, vrMow, EBo, zoE, efM, UqMgkQ, ottVOY, Iig, Vas, rhtatX, lyIDy, JAgscH, CpX, COZAP, SjXC, jysrBK, Jnf, tgQ, BwqLK, Wvg, zyC, iiQ, zgFme, YZFb, cWN, bdXRm, qpp, lVmL, quRl, VtcRxd, Vdi, fwpop, qGsXK, HfJHTd, WebVP, yDcGKz, mBYPSp, cNVrB, whqSX, qQHmX, JdC, oBP, vXaL, aqmd, ibmjcg, zJdnmU, oTCVL, vsE, LIl, yjZ, qDOu, hDc, OlNNEr, pPyta, psvK, OYB, jOKtXR, IhCSo, dMkI, tuu, Sfz, WOYE, kSEzN,

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