Haglund Syndrome - MSK Radiology
Imaging Findings:
• The Haglund Deformity (enlarged superior margin calcaneal posterior process)
• Partial undersurface tear of the Achilles tendon insertion with adjacent heterogeneous signal.
• Thickened mid-substance Achilles tendon (>7mm) with anterior convex margin consistent with superimposed tendinosis.
• T2-hyperintense and T1-hypointense signal within the retrocalcaneal bursa.
Case description:
• Haglund syndrome: Haglund deformity, insertional tendinopathy, pre-Achilles/retrocalcaneal bursitis.
- Wearing high-heels or stiff-backed shoes ("Pump-bump")
• Pre-Achilles/retrocalcaneal bursa can have a very small amount of fluid in asymptomatic patients.
>1 mm AP, 11 mm TV, 7mm CC size of bursa is commonly abnormal.
• Insertional tendinopathy: distal tendon thickening (>7mm) with signal heterogeneity & possible tear.
- Tendinosis: usually occurs midsubstance.
Differential diagnosis:
• Inflammatory Arthritis: Often presents with retrocalcaneal bursitis but usually erosions of calcaneus.
• Stress fracture of calcaneus: Often involves posterior calcaneus with marrow edema.
Dr. Donald von Borstel @DrvonBorstel
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