Novel Radiographic Measurements for Operatively Treated Haglund's Deformity

Area of Science:

• Orthopedics
• Radiology
• Podiatry

Background:

• Haglund's deformity causes posterior heel pain due to a bony prominence on the calcaneus.
• Current diagnostic methods lack a standard radiographic parameter for symptomatic cases.

Purpose of the Study:

• To introduce and validate novel radiographic measurements for diagnosing symptomatic Haglund's deformity.
• To differentiate between patients with and without symptomatic Haglund's deformity using new parameters.

Main Methods:

• Retrospective analysis of ankle radiographs from 43 Haglund's deformity patients and 41 controls.
• Measurement and comparison of Fowler-Phillip angle (FPA), parallel pitch lines (PPL), Haglund's deformity height, bump height, and bump-calcaneus ratio.
• Validation of reliability and cut-off values using ICC and ROC curve analysis.

Main Results:

• Bump height and bump-calcaneus ratio showed significant differences between groups (p < 0.001).
• Bump-calcaneus ratio demonstrated higher diagnostic accuracy (AUC) than bump height.
• Optimal thresholds: bump height ≥ 4 mm, bump-calcaneus ratio ≥ 7.5%.

Conclusions:

• Bump height and bump-calcaneus ratio are effective, intuitive radiographic parameters for identifying surgically treated Haglund's deformity.
• The bump-calcaneus ratio is a more reliable diagnostic parameter than bump height.
• These novel measurements aid in diagnosing symptomatic Haglund's deformity.