Comparison of Radiographic Parameters Used to Assess Haglund Deformities in an Asian Population: A Case–Control Study

Introduction: Posterior heel pain is a frequently observed manifestation of foot and ankle discomfort. The condition is primarily attributed to many types of soft tissue disorders, such as bursitis and tendinopathy, as well as bone abnormalities such as posterosuperior deformity and posterior calcan...

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Main Authors: Fu Yuen Thong, Tanawat Vaseenon, Theenesh Theyvan, Pawee Chalidapong, Jirawat Saengsin
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2024-12-01
Series:Journal of Foot and Ankle Surgery (Asia Pacific)
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Online Access:https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1375
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author Fu Yuen Thong
Tanawat Vaseenon
Theenesh Theyvan
Pawee Chalidapong
Jirawat Saengsin
author_facet Fu Yuen Thong
Tanawat Vaseenon
Theenesh Theyvan
Pawee Chalidapong
Jirawat Saengsin
author_sort Fu Yuen Thong
collection DOAJ
description Introduction: Posterior heel pain is a frequently observed manifestation of foot and ankle discomfort. The condition is primarily attributed to many types of soft tissue disorders, such as bursitis and tendinopathy, as well as bone abnormalities such as posterosuperior deformity and posterior calcaneal spur. The management of these diverse entities should be delineated based on the underlying etiology of pain. Lateral calcaneus radiography is employed to detect bone pathology associated with this condition. Nevertheless, the predictive efficacy of all bone and spur measuring parameters remains equivocal. The objective was to assess the predictive efficacy of a novel radiographic test, known as bone prominence measurement (BPM), in comparison to existing methods. Materials and methods: A total of 184 individuals were categorized into two groups based on the presence or absence of posterior heel pain: symptomatic and asymptomatic. The weight-bearing lateral radiography measurements of the <italic>X</italic>/<italic>Y</italic> ratio, Fowler–Philip angle (FPA), Heneghan–Pavlov parallel pitch line (HPPPL), Chauveaux–Liet angle (CLA), and BPM were examined using a Chi-squared test. Results: There was no statistically significant difference between the two symptomatic groups in terms of <italic>X</italic>/<italic>Y</italic> ratio, FPA, and CLA. The HPPPL exhibited a notable disparity in the symptomatic group but demonstrated low specificity and positive predictive value (PPV). The 5 mm bony prominence’s BPM parameter demonstrated a PPV of 90.4%, a sensitivity of 90.4%, and a specificity of 90.0%. A statistically significant difference was seen in BPM with a <italic>p</italic>-value of 0.001. Conclusion: BPM is a useful marker for confirming the presence of symptomatic posterior heel pain. The size of the posterior heel spur may be associated with improper tension on the Achilles tendon and the alleviation of symptoms following surgical removal.
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spelling doaj-art-5ec0e77e3cd34a9d87ae1401547b60482025-08-20T02:08:31ZengJaypee Brothers Medical PublisherJournal of Foot and Ankle Surgery (Asia Pacific)2348-280X2394-77052024-12-0112161010.5005/jp-journals-10040-13753Comparison of Radiographic Parameters Used to Assess Haglund Deformities in an Asian Population: A Case–Control StudyFu Yuen Thong0Tanawat Vaseenon1Theenesh Theyvan2Pawee Chalidapong3Jirawat Saengsin4Department of Orthopaedics, Queen Elizabeth Hospital II, Kota Kinabalu, Sabah, MalaysiaTanawat Vaseenon, Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, Phone: +66 53935544Department of Orthopedics, Hospital Raja Permaisuri Bainun, Ipoh, Perak, MalaysiaDepartment of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandIntroduction: Posterior heel pain is a frequently observed manifestation of foot and ankle discomfort. The condition is primarily attributed to many types of soft tissue disorders, such as bursitis and tendinopathy, as well as bone abnormalities such as posterosuperior deformity and posterior calcaneal spur. The management of these diverse entities should be delineated based on the underlying etiology of pain. Lateral calcaneus radiography is employed to detect bone pathology associated with this condition. Nevertheless, the predictive efficacy of all bone and spur measuring parameters remains equivocal. The objective was to assess the predictive efficacy of a novel radiographic test, known as bone prominence measurement (BPM), in comparison to existing methods. Materials and methods: A total of 184 individuals were categorized into two groups based on the presence or absence of posterior heel pain: symptomatic and asymptomatic. The weight-bearing lateral radiography measurements of the <italic>X</italic>/<italic>Y</italic> ratio, Fowler–Philip angle (FPA), Heneghan–Pavlov parallel pitch line (HPPPL), Chauveaux–Liet angle (CLA), and BPM were examined using a Chi-squared test. Results: There was no statistically significant difference between the two symptomatic groups in terms of <italic>X</italic>/<italic>Y</italic> ratio, FPA, and CLA. The HPPPL exhibited a notable disparity in the symptomatic group but demonstrated low specificity and positive predictive value (PPV). The 5 mm bony prominence’s BPM parameter demonstrated a PPV of 90.4%, a sensitivity of 90.4%, and a specificity of 90.0%. A statistically significant difference was seen in BPM with a <italic>p</italic>-value of 0.001. Conclusion: BPM is a useful marker for confirming the presence of symptomatic posterior heel pain. The size of the posterior heel spur may be associated with improper tension on the Achilles tendon and the alleviation of symptoms following surgical removal.https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1375achilles tendinopathycalcaneal morphologyhaglund syndromeheel spurposterior heel painradiographic measurement
spellingShingle Fu Yuen Thong
Tanawat Vaseenon
Theenesh Theyvan
Pawee Chalidapong
Jirawat Saengsin
Comparison of Radiographic Parameters Used to Assess Haglund Deformities in an Asian Population: A Case–Control Study
Journal of Foot and Ankle Surgery (Asia Pacific)
achilles tendinopathy
calcaneal morphology
haglund syndrome
heel spur
posterior heel pain
radiographic measurement
title Comparison of Radiographic Parameters Used to Assess Haglund Deformities in an Asian Population: A Case–Control Study
title_full Comparison of Radiographic Parameters Used to Assess Haglund Deformities in an Asian Population: A Case–Control Study
title_fullStr Comparison of Radiographic Parameters Used to Assess Haglund Deformities in an Asian Population: A Case–Control Study
title_full_unstemmed Comparison of Radiographic Parameters Used to Assess Haglund Deformities in an Asian Population: A Case–Control Study
title_short Comparison of Radiographic Parameters Used to Assess Haglund Deformities in an Asian Population: A Case–Control Study
title_sort comparison of radiographic parameters used to assess haglund deformities in an asian population a case control study
topic achilles tendinopathy
calcaneal morphology
haglund syndrome
heel spur
posterior heel pain
radiographic measurement
url https://www.jfasap.com/doi/JFASAP/pdf/10.5005/jp-journals-10040-1375
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