Pain at the back of heel.
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Spur on the posterior proximal calcaneus (a Haglund deformity) and erosion on the posterior calcaneus with a thickened distal Achilles tendon. MRI revealed marrow edema of the posterior calcaneal tuberosity with retro-Achilles and retrocalcaneal burstis. There is high signal intensity with focal enlargement at the Achilles tendon insertion and calcaneal bony spur.
This disorder is often caused by ill-fitting shoes that compress the distal Achilles tendon. Bony overgrowth and/or erosions of the proximal posterior calcaneus may be associated with this condition.
Case courtesy of Prof. Ali Hekmatnia.