Defining Haglund's deformity radiographically by incorporating the biomechanics of ankle motion

Abstract

Background: Haglund's deformity is clinically defined by the presence of retrocalcaneal tenderness, with previous radiographic parameters relying on calcaneal anatomic parameters that did not considering the influence of ankle motion on posterior calcaneal-Achilles impingement METHODS: Standing foot radiographs from 55 patients with clinically defined Haglund's deformity were compared to 50 control patients using previously described measurements and 2 new angular measurements based on the linkage between ankle rotation and posterior calcaneal-Achilles impingement. The ability of each measure to distinguish between Haglund's and control patients was assessed.

Results: The combination of the angles to account for both increased calcaneal tubercle height and increased posterior calcaneal prominence could distinguish between the two patient groups (p = .018, Area under the curve = 63.2%). None of the previously published radiographic criteria were different between the two patient groups.

Conclusions: The proposed radiographic criteria were more predictive than previous criteria that did not address the role of ankle motion.

Keywords: Ankle biomechanics; Haglund's Deformity; Radiograph; Retrocalcaneal bursitis.