Presentation
Persistent heel pain, after a fall down stairs 4 weeks ago.
Patient Data
PD mDixon and T1w images show an incomplete, non-displaced, extraarticular fracture of the calcaneal tuberosity extending to the medial surface.
Fat-saturated PD mDixon shows mild surrounding bone marrow edema and also a high signal change of the quadratus plantae muscle consistent with edema/hematoma.
Syndesmosis, talofibular, calcaneofibular and deltoid ligaments as well as peronael, long flexor and extensor tendons as well as the Achilles tendon are intact.
A follow-up x-ray of the calcaneus 14 days later shows a sclerotic line running through the posterior calcaneal tuberosity.
Case Discussion
This case demonstrates an incomplete, non-displaced, extraarticular fracture of the calcaneal tuberosity.
In this case, the patient had a single traumatic event (compression injury after fall downstairs) which caused this incomplete fracture.
There was no evidence for long-distance running or other forms of overuse in the patient history since the images would be also typical of a stress fracture.
Nondisplaced and noncomminuted calcaneal fractures may be treated conservatively with non-weight bearing for 6-8 weeks and casting or other protective footwear.