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Canberra, Australian Capital Territory, Australia
"Jack of all (sports), Master of none!"

26 March 2007

The heel in detail...

The name - Haglund's deformity:
Patrick Haglund was the first to describe a deformity associated with pain to the back of the heel in 1928. He identified pain associated with bony prominence to the posterior superiolateral aspect of the calcaneus. A Haglund’s deformity or “pump bump” is described as a ridge of bone along the posterior superior lateral ridge of the calcaneus. Irritation and bone prominent in this area will often cause bursal inflammation of the Achilles bursa and lead to a painful swelling and discomfort to the back of the heel. Many times there is an associated calcification or spur to the posterior portion of the calcaneus.

The anatomy:
In the figure below (1) corresponds to the superior ridge of the calcaneus (red). Hypertrophy of bone to this ridge along its superior border is considered the classic Haglund’s deformity. This area is devoid of Achilles attachment. No fibres of the Achilles tendon attaches in this area. As the Achilles tendon traverses along the posterior heel, (2) the Achilles bursa (green) sits directly in front of the Achilles tendon along the superior half of the posterior calcaneus. (3) There is a bone ridge corresponding to the posterior calcaneal tuberosity where the majority of the Achilles tendon is attached (blue). The tuberosity is located more central along the posterior calcaneus.


The above information and picture was sourced from an article in the Podiatry Internet Journal: “Haglund’s Correction with Removal of Retrocalcaneal Spur and Transverse Achilles Tenoplasty: 2 Case Reports”

My diagnosis:
Tendinosis of Achilles, both peroneus tendons and tibialis posterior. Haglund’s deformity associated retrocalcaneal bursitis and calcaneal osteitis.

My heel viewed laterally or from the outside...

My heel viewed medially or from the inside...

My heel viewed from the rear...

3 comments:

Gronk said...

Hope it's all going well AR. :)

Aki said...

As am I.

Friar said...

It's not as bad looking at your heel as it was looking at CJ's knee.