UMEM Educational Pearls

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Haglund’s deformity

Calcaneal bony growth at the Achilles insertion

Also known as a “pump bump”

Risks: Tight & rigid shoes. Shoes with a hard heel counter. High arches. Tight Achilles tendon. Repetitive heel stress (jumping). Genetically prone bone structures.

Most common in woman between the ages of 15 and 35. Wearing heels. Runners.

Hx: Heel pain and tenderness with a noticeable bump at back of heel. Worse with walking and with certain footwear. 

PE: Swelling and redness around bony prominence. 

Pain and tenderness in the posterior heel, especially when pressure is applied.

Imaging: Excessive traction and abnormal biomechanics lead to insertional calcifications and bone spurs.

 Over time, an exostosis may develop at posterior superior calcaneus as shown in the attached film.

Tx: Physical therapy and orthotics that alter heel height in shoe.

Surgery for chronic cases.