Radiological angle assessment of Haglund's deformity: validation on Magnetic Resonance Imaging.

Area of Science:

• Orthopedic imaging
• Radiology
• Foot and ankle anatomy

Background:

• Haglund's deformity causes posterior heel pain.
• Radiological measurements aid in differentiating symptomatic and asymptomatic cases.
• Traditional assessments use plain radiographs.

Purpose of the Study:

• To identify radiological measurements applicable to Magnetic Resonance Imaging (MRI) for Haglund's deformity.
• To evaluate the diagnostic utility of specific angles and distances on MRI.

Main Methods:

• Retrospective analysis of 30 Haglund's deformity MRI studies and 32 controls.
• Measurement of the angle of BRINK, Achilles angle, Calcaneal pitch, Achilles-plantar fascia angle, and soleus calcaneal distance.
• Utilized optimal T2 fat-saturated sagittal MRI slices.

Main Results:

• The angle of BRINK showed statistically significant difference (p < 0.0001) between groups with good discrimination (AUC = 0.7783).
• Angle of BRINK measurement demonstrated high reproducibility (ICC > 0.82).
• Achilles tendon insertion site, calcaneal edema, and non-insertional tendinopathy were more prevalent in the Haglund's group.

Conclusions:

• The angle of BRINK is a reliable MRI measurement for differentiating Haglund's deformity.
• This measurement can potentially enhance patient management and surgical decision-making.
• Further research should correlate the angle of BRINK with long-term patient outcomes.