Increased heel pad thickness, also known as the heel pad sign, is seen in a number of conditions and relates to an increase in the soft-tissue thickness of the heel pad on lateral ankle radiographs.
The heel pad should normally be <25 mm 1,2. However, in certain pathological situations, this is increased:
- acromegaly
- myxedema
- callus formation
- phenytoin therapy
- obesity
- peripheral edema
A useful acronym for remembering the causes is MAD COP.
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