Haglund syndrome and deformity
Elderly lady presenting with pain and swelling at the Achilles tendon insertion onto the posterior calcaneus.
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Swelling of the Achilles tendon was mainly distal rather than mid-tendon. Kager fat pad was echogenic. Hyperemia of the tendon, fat pad and bursa was observed. There was probable spurring at the Achilles insertion. There was retrocalcaneal bursitis.
The overall picture suggested Haglund syndrome with spurring at the Achilles insertion and the patient's site of pain.
The presence of retrocalcaneal pain and bursitis suggested an underlying Haglund deformity. A specialist determined x-ray was performed, which confirmed spurring and revealed a small Haglund deformity (not shown).