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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

12 Cases of Haglund’s Syndrome Detected through MRI

Author(s): Shuwei Zhou, Wuxing Luo, Siyu Wang and Kun Zhang*

Volume 19, Issue 9, 2023

Published on: 09 March, 2023

Article ID: e090323214501 Pages: 5

DOI: 10.2174/1573405619666230309102638

Price: $65

Abstract

Background: Haglund’s syndrome is a common cause of heel pain but often neglected clinically. Haglund’s syndrome refers to a series of symptoms caused by impingement among posterosuperior prominence of the calcaneus, bursa and Achilles tendon. It is difficult to distinguish Haglund’s syndrome from other causes of heel pain by clinical diagnosis. Imageology is of great value in the diagnosis of Haglund’s syndrome.

Objective: Our study aims to summarize the Magnet resonance (MR) imaging characteristics of Haglund’s syndrome and provide some reference to clinical work.

Method: We retrospectively analyzed the MR images of 11 patients (6 males; 5 females; 6 right ankles, 4 left ankles, 1 bimalleolar ankles) who have been clinically and radiologically confirmed Haglund’s syndrome. Observation contents: morphological changes of calcaneus and talus, abnormal signal of calcaneus, abnormal Achilles tendon, and soft tissue abnormalities around Achilles tendon. Combined with literature reviews, summarize the MR imaging features of Haglund’s syndrome.

Results: In 12 ankles, all ankles showed posterosuperior prominence of the calcaneus and Achilles tendon degeneration; 7 ankles showed bone marrow edema; 6 Achilles tendons were graded as either type II or type III tendinosis; 5 Achilles tendons showed partial tear; 12 ankles showed retrocalcaneal bursitis, 7 ankles showed retro-Achilles bursitis, 6 ankles showed Kager’s fat pad edema.

Conclusion: This study found that MR images of Haglund's syndrome showed bone edema of the calcaneus, degeneration and partial tear of the Achilles tendon, the retrocalcaneal and retro-Achilles bursas, and Kager’s fat pad edema.

[1]
Pavlov H, Heneghan MA, Hersh A, Goldman AB, Vigorita V. The Haglund syndrome: Initial and differential diagnosis. Radiology 1982; 144(1): 83-8.
[http://dx.doi.org/10.1148/radiology.144.1.7089270] [PMID: 7089270]
[2]
Millar NL, Silbernagel KG, Thorborg K, et al. Tendinopathy. Nat Rev Dis Primers 2021; 7(1): 1.
[http://dx.doi.org/10.1038/s41572-020-00234-1] [PMID: 33414454]
[3]
van der Worp MP, ten Haaf DSM, van Cingel R, de Wijer A, Nijhuisvan der SMWG, Staal JB. Injuries in runners; A systematic review on risk factors and sex differences. PLoS One 2015; 10(2): e0114937.
[http://dx.doi.org/10.1371/journal.pone.0114937] [PMID: 25706955]
[4]
Vaishya R, Agarwal AK, Azizi AT, Vijay V. Haglund’s syndrome: A commonly seen mysterious condition. Cureus 2016; 8(10): e820.
[http://dx.doi.org/10.7759/cureus.820] [PMID: 27843738]
[5]
Hodgkins CW, Wessling NA. Epidemiology of sports-specific foot and ankle injuries. Foot Ankle Clin 2021; 26(1): 173-85.
[http://dx.doi.org/10.1016/j.fcl.2020.10.001] [PMID: 33487239]
[6]
Kraemer R, Wuerfel W, Lorenzen J, Busche M, Vogt PM, Knobloch K. Analysis of hereditary and medical risk factors in Achilles tendinopathy and Achilles tendon ruptures: A matched pair analysis. Arch Orthop Trauma Surg 2012; 132(6): 847-53.
[http://dx.doi.org/10.1007/s00402-012-1476-9] [PMID: 22350054]
[7]
Debus F, Eberhard HJ, Olivieri M, Peterlein CD. MRI in patients with Haglund’s deformity and its influence on therapy. Arch Orthop Trauma Surg 2019; 139(7): 903-6.
[http://dx.doi.org/10.1007/s00402-019-03122-w] [PMID: 30666401]
[8]
Chauveaux D, Liet P, Le Huec JC, Midy D. A new radiologic measurement for the diagnosis of Haglund’s deformity. Surg Radiol Anat 1991; 13(1): 39-44.
[http://dx.doi.org/10.1007/BF01623140] [PMID: 2053043]
[9]
Nicholson CW, Berlet GC, Lee TH. Prediction of the success of nonoperative treatment of insertional Achilles tendinosis based on MRI. Foot Ankle Int 2007; 28(4): 472-7.
[http://dx.doi.org/10.3113/FAI.2007.0472] [PMID: 17475142]
[10]
Adigo AM, Gnakadja NG, Dellanh YY, et al. Haglund deformity: Report of three cases. Pan Afr Med J 2015; 22: 37.
[http://dx.doi.org/10.11604/pamj.2015.22.37.7866] [PMID: 26664538]
[11]
Chang CD, Wu JS. MR imaging findings in heel pain. Magn Reson Imaging Clin N Am 2017; 25(1): 79-93.
[http://dx.doi.org/10.1016/j.mric.2016.08.011] [PMID: 27888853]
[12]
Abelkis E, Willekens I, Boulet C, et al. Pseudo-tear appearance of the Achilles tendon on MR imaging in normal volunteers. Surg Radiol Anat 2021; 43(1): 73-7.
[http://dx.doi.org/10.1007/s00276-020-02542-3] [PMID: 32743716]
[13]
Lu CC, Cheng YM, Fu YC, Tien YC, Chen SK, Huang PJ. Angle analysis of Haglund syndrome and its relationship with osseous variations and Achilles tendon calcification. Foot Ankle Int 2007; 28(2): 181-5.
[http://dx.doi.org/10.3113/FAI.2007.0181] [PMID: 17296136]
[14]
Singh R, Rohilla R, Siwach RC, Magu NK, Sangwan SS, Sharma A. Diagnostic significance of radiologic measurements in posterior heel pain. Foot 2008; 18(2): 91-8.
[http://dx.doi.org/10.1016/j.foot.2008.01.005] [PMID: 20307418]
[15]
Bulstra GH, van Rheenen TA, Scholtes VAB. Can we measure the heel bump? radiographic evaluation of Haglund’s deformity. J Foot Ankle Surg 2015; 54(3): 338-40.
[http://dx.doi.org/10.1053/j.jfas.2014.07.006] [PMID: 25179453]
[16]
Szaro P, Geijer M, Solidakis N. Traumatic and non-traumatic bone marrow edema in ankle MRI: A pictorial essay. Insights Imaging 2020; 11(1): 97.
[http://dx.doi.org/10.1186/s13244-020-00900-8] [PMID: 32804284]
[17]
Lawrence DA, Rolen MF, Morshed KA, Moukaddam H. MRI of heel pain. AJR Am J Roentgenol 2013; 200(4): 845-55.
[http://dx.doi.org/10.2214/AJR.12.8824] [PMID: 23521459]
[18]
Pierre-Jerome C, Moncayo V, Terk MR. MRI of the Achilles tendon: A comprehensive review of the anatomy, biomechanics, and imaging of overuse tendinopathies. Acta Radiol 2010; 51(4): 438-54.
[http://dx.doi.org/10.3109/02841851003627809] [PMID: 20380605]
[19]
Kucuksen S, Karahan AY, Erol K. Haglund syndrome with pump bump. Med Arh 2012; 66(6): 425-7.
[http://dx.doi.org/10.5455/medarh.2012.66.425-427] [PMID: 23409529]
[20]
Rhim HC, Kim MS, Choi S, Tenforde AS. Comparative efficacy and tolerability of nonsurgical therapies for the treatment of midportion achilles tendinopathy: A systematic review with network meta-analysis. Orthop J Sports Med 2020; 8(7): 2325967120930567.
[http://dx.doi.org/10.1177/2325967120930567] [PMID: 32728589]
[21]
Silbernagel KG, Hanlon S, Sprague A. Current clinical concepts: Conservative management of achilles tendinopathy. J Athl Train 2020; 55(5): 438-47.
[http://dx.doi.org/10.4085/1062-6050-356-19] [PMID: 32267723]
[22]
van der Vlist AC, Winters M, Weir A, et al. Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials. Br J Sports Med 2021; 55(5): 249-56.
[http://dx.doi.org/10.1136/bjsports-2019-101872] [PMID: 32522732]
[23]
Longo UG, Ronga M, Maffulli N. Achilles tendinopathy. Sports Med Arthrosc Rev 2018; 26(1): 16-30.
[http://dx.doi.org/10.1097/JSA.0000000000000185] [PMID: 29300224]
[24]
Choo YJ, Park CH, Chang MC. Rearfoot disorders and conservative treatment: A narrative review. Ann Palliat Med 2020; 9(5): 3546-52.
[http://dx.doi.org/10.21037/apm-20-446] [PMID: 32787369]
[25]
Baltes TPA, Zwiers R, Wiegerinck JI, van Dijk CN. Surgical treatment for midportion Achilles tendinopathy: A systematic review. Knee Surg Sports Traumatol Arthrosc 2017; 25(6): 1817-38.
[http://dx.doi.org/10.1007/s00167-016-4062-9] [PMID: 26971111]
[26]
Alfredson H. Low recurrence rate after mini surgery outside the tendon combined with short rehabilitation in patients with midportion Achilles tendinopathy. Open Access J Sports Med 2016; 7: 51-4.
[http://dx.doi.org/10.2147/OAJSM.S102692] [PMID: 27274323]
[27]
Calder JDF, Stephen JM, van Dijk CN. Plantaris excision reduces pain in midportion achilles tendinopathy even in the absence of plantaris tendinosis. Orthop J Sports Med 2016; 4(12): 2325967116673978.
[http://dx.doi.org/10.1177/2325967116673978] [PMID: 28203584]

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