Ultrasonographic assessment of posterior heel pain

To investigate the value of ultrasonography in the diagnosis of posterior heel pain, 68 patients with normal plain x-ray findings of the posterior heel underwent ultrasonographic examination with a 10-MHz linear array probe. The findings included Achilles tendinosis (31 patients), retrocalcaneal bursitis (12), superficial Achilles bursitis (7), soft tissue mass (7), Achilles tendon rupture (4), xanthoma (3), tenosynovitis of the flexor hallucis longus tendon (2), and negative findings (2). Sixteen of these patients underwent surgery after ultrasonographic examination. The surgical diagnoses were consistent with the ultrasonographic diagnoses in all cases. With high-resolution ultrasonography, pathologic conditions of the posterior heel can be readily differentiated.