Presentation
Pain and swelling in the back of the heel.
Patient Data
focal enlargement, abnormal high PD fat sat signal and insertional calcifications in the distal Achilles tendon (Achilles insertional tendinopathy) along with partial insertional tear
retrocalcaneal bursal distension by a fluid collection appears as a low signal on T1, a high signal on PD fat sat (retrocalcaneal bursitis)
posterosuperior calcaneal bony spur (Haglund deformity)
marrow edema in the posterior calcaneal tuberosity
Annotated images:
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first image: haglund syndrome triad:
Achilles insertional tendinopathy (green arrows) with partial insertional tear
retrocalcaneal bursitis (blue arrow)
posterosuperior calcaneal bony spur (red dotted line)
the second image illustrates the impact of high-heeled pumps on the pathogenesis of Haglund syndrome
Case Discussion
Haglund’s syndrome is the consequence of Haglund deformity that occurs when there’s chronic pressure on the backs of the heels especially when wearing shoes that are too tight or rigid in the heel. It often develops in women who wear pump-style high heels, hence the appellation “pump bump.”
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