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Haglund deformity with insertional Achilles tendinosis

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Pain and swelling related to the posterior aspect of the heel.

Patient Data

Age: 60 years
Gender: Male

A small bony prominence is seen in the posterior superior aspect of the calcaneus bone. Partial obliteration of the Kager pad of fat is seen suggestive of retrocalcaneal bursitis.

The distal tendo-Achilles shows mild thickening with intra-substance intermediate signal intensity in all sequences.

A lobulated 2.7 X 1.8 cm cystic lesion is seen at the retro-calcaneal region representing distended bursa.

A small bony prominence is seen at the posterior superior calcaneus.

Marrow edema signal of the dorsal calcaneus with patchy area of low T1 and high STIR and GRE signal.

Intact other tendons around the hind foot

Normal collateral ligaments.

No joint effusion.

Case Discussion

The above described findings are those of Haglund deformity of the dorsal calcaneus with distal (insertional) Achilles tendinitis as well as retrocalcaneal bursitis and marrow edema of the dorsal calcaneus.

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