HSS Ultrasound of the Month Case 81

Clinical History 45-year-old female with progressive heel pain without history of antecedent trauma X-ray showed an osseous protuberance along the superior portion of the calcaneal tuberosity

Ultrasound of the Month – Case 81

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Ultrasound of the Month – Case 81

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Ultrasound of the Month – Case 81

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Ultrasound of the Month – Case 81

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Ultrasound of the Month – Case 81

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Diagnosis: Haglund syndrome Discussion Haglund syndrome is a constellation of soft tissue abnormalities associated with an osseous prominence of the calcaneal tuberosity.

The osseous prominence is referred to as a Haglund deformity or “pump bump”, because it is commonly associated with women’s pumps.

Soft tissue abnormalities that make up Haglund syndrome consist of insertional Achilles tendinosis, retrocalcaneal bursitis, and retroAchilles bursitis. These can be identified on either MRI or ultrasound.

Ultrasound has the advantage of allowing for a guided cortisone injection during the same visit.

Cortisone injection into the retrocalcaneal bursa can be performed safely under ultrasound.

Because the Haglund bump is believed to be contributory, the cortisone injection may only provide short-term relief and these patients may be candidates for surgical resection of the osseous protuberance of the calcaneal tuberosity.

Ultrasound of the Month – Case 81

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