Haglund’s deformity can result in a painful posterior heel.


Synonym: “pump bump” (pump = woman’s shoe)


Haglund’s deformity is an enlarged retrocalcaneal bursa.


If the bursa becomes inflamed (bursitis) then the pain and swelling is termed Haglund’s disease.


When a person wears a shoe, compression of the Achilles tendon and adjacent soft tissue between the os calcis and the posterior shoe counter can worsen the pain.


Imaging findings (Stephens, 1994):

(1) superior calcaneal angle > 75 degrees

(2) calcaneal inclination and posterior calcaneal angle > 90 degrees

(3) excessive bone above the upper parallel pitch line


Differential diagnosis:

(1) disorders of the Achilles tendon

(2) calcaneal fracture

(3) rheumatoid arthritis or other autoimmune disease


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