Post traumatic achilles tendon ossification
Remote history of ankle trauma 20 years ago with chronic posterior ankle pain
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Approximately 3 to 4 cm proximal to the achilles tendon insertion on the calcaneum, there are areas of amorphous calcification with a focal bulge. the achilles tendon fibers are not discontinuous. Other incidental findings include a loose body in posterior recess of talar joint, inferior calcaneal spur, and mild heel fat pad edema.
Dystrophic calcification occurs in tendons at sites of trauma / injury or repetitive stress as demonstrated here. Whilst insertional site is a common location of repetitive stress, in this case, the history of an old trauma is the culprit for the more proximal calcification.