Correlations between insertional Achilles tendinopathy and haglund’s deformity: MRI and radiographic findings

Abstract Background The relationship between insertional Achilles tendinopathy (IAT) and Haglund’s deformity has not been fully elucidated. This study aimed to determine the optimal cutoff value of MRI-based Achilles thickness and intratendinous degeneration for IAT and further explored the correlat...

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Main Authors: Shih-Chieh Tang, Han-Ting Shih, Yu-Hsien Wu, Shun-Ping Wang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-025-06036-z
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author Shih-Chieh Tang
Han-Ting Shih
Yu-Hsien Wu
Shun-Ping Wang
author_facet Shih-Chieh Tang
Han-Ting Shih
Yu-Hsien Wu
Shun-Ping Wang
author_sort Shih-Chieh Tang
collection DOAJ
description Abstract Background The relationship between insertional Achilles tendinopathy (IAT) and Haglund’s deformity has not been fully elucidated. This study aimed to determine the optimal cutoff value of MRI-based Achilles thickness and intratendinous degeneration for IAT and further explored the correlations of IAT and Haglund’s deformity. Materials and methods Thirty heels with symptomatic IAT (IAT group) underwent surgeries and 38 healthy participants without heel pain (control group) were enrolled. Five different radiographic parameters for diagnosing Haglund’s deformity were measured. The IAT changes including tendon thickness and intratendinous degenerative ratio (ITD ratio) were obtained on MRI. The correlations of IAT and different radiographic parameters of Haglund’s deformity were evaluated. Results A total of 68 feet were enrolled. The optimal thresholds of Achilles tendon thickness and ITD ratio were 6.1 mm and 48.8%, respectively. Both tendon thickness and ITD ratio were positively correlated with bump height and bump-calcaneus ratio (p < 0.001), but Fowler–Phillip angle, Heneghan–Pavlov parallel pitch lines and X-Y ratio were not. Conclusion Achilles tendon thickness of more than 6.1 mm and intratendinous abnormality of over 48.8% were confirmed to be diagnostic cutoff values for IAT. Haglund’s deformity was determined as a risk factor of IAT requiring surgery. Both radiographic parameters of Haglund’s deformity using the bump height and the bump-calcaneus ratio were useful in predicting the presence of IAT on MRI. Level of clinical evidence Level III, Retrospective cohort study.
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spelling doaj-art-dc8587ba7c3747ecb83020ccc8580e1b2025-08-20T03:46:21ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-07-012011810.1186/s13018-025-06036-zCorrelations between insertional Achilles tendinopathy and haglund’s deformity: MRI and radiographic findingsShih-Chieh Tang0Han-Ting Shih1Yu-Hsien Wu2Shun-Ping Wang3Department of Orthopaedics, Taichung Veterans General HospitalDepartment of Orthopaedics, Taichung Veterans General HospitalDepartment of Orthopaedics, Taichung Veterans General HospitalDepartment of Orthopaedics, Taichung Veterans General HospitalAbstract Background The relationship between insertional Achilles tendinopathy (IAT) and Haglund’s deformity has not been fully elucidated. This study aimed to determine the optimal cutoff value of MRI-based Achilles thickness and intratendinous degeneration for IAT and further explored the correlations of IAT and Haglund’s deformity. Materials and methods Thirty heels with symptomatic IAT (IAT group) underwent surgeries and 38 healthy participants without heel pain (control group) were enrolled. Five different radiographic parameters for diagnosing Haglund’s deformity were measured. The IAT changes including tendon thickness and intratendinous degenerative ratio (ITD ratio) were obtained on MRI. The correlations of IAT and different radiographic parameters of Haglund’s deformity were evaluated. Results A total of 68 feet were enrolled. The optimal thresholds of Achilles tendon thickness and ITD ratio were 6.1 mm and 48.8%, respectively. Both tendon thickness and ITD ratio were positively correlated with bump height and bump-calcaneus ratio (p < 0.001), but Fowler–Phillip angle, Heneghan–Pavlov parallel pitch lines and X-Y ratio were not. Conclusion Achilles tendon thickness of more than 6.1 mm and intratendinous abnormality of over 48.8% were confirmed to be diagnostic cutoff values for IAT. Haglund’s deformity was determined as a risk factor of IAT requiring surgery. Both radiographic parameters of Haglund’s deformity using the bump height and the bump-calcaneus ratio were useful in predicting the presence of IAT on MRI. Level of clinical evidence Level III, Retrospective cohort study.https://doi.org/10.1186/s13018-025-06036-zHaglund’s deformityInsertional achilles tendinopathyHeel painAchilles tendon
spellingShingle Shih-Chieh Tang
Han-Ting Shih
Yu-Hsien Wu
Shun-Ping Wang
Correlations between insertional Achilles tendinopathy and haglund’s deformity: MRI and radiographic findings
Journal of Orthopaedic Surgery and Research
Haglund’s deformity
Insertional achilles tendinopathy
Heel pain
Achilles tendon
title Correlations between insertional Achilles tendinopathy and haglund’s deformity: MRI and radiographic findings
title_full Correlations between insertional Achilles tendinopathy and haglund’s deformity: MRI and radiographic findings
title_fullStr Correlations between insertional Achilles tendinopathy and haglund’s deformity: MRI and radiographic findings
title_full_unstemmed Correlations between insertional Achilles tendinopathy and haglund’s deformity: MRI and radiographic findings
title_short Correlations between insertional Achilles tendinopathy and haglund’s deformity: MRI and radiographic findings
title_sort correlations between insertional achilles tendinopathy and haglund s deformity mri and radiographic findings
topic Haglund’s deformity
Insertional achilles tendinopathy
Heel pain
Achilles tendon
url https://doi.org/10.1186/s13018-025-06036-z
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AT yuhsienwu correlationsbetweeninsertionalachillestendinopathyandhaglundsdeformitymriandradiographicfindings
AT shunpingwang correlationsbetweeninsertionalachillestendinopathyandhaglundsdeformitymriandradiographicfindings