Radiological association between Haglund's deformity and plantar calcaneal spur: A retrospective case-control study
Volkan Özel1, Ibrahim Halil Demir2, Nevzat Gönder3
1Department of Orthopaedics and Traumatology, Şehit Sait Ertürk State Hospital, Ankara, Turkey.
Journal of Orthopaedic Surgery (Hong Kong)
|October 3, 2025
Summary
Plantar calcaneal spur (PCS) and Haglund's deformity share common biomechanical stress pathways. Haglund's deformity is significantly more common in patients with PCS, suggesting a linked etiology for these heel pain conditions.
Area of Science:
- Orthopedics
- Podiatry
- Radiology
Background:
- Plantar calcaneal spur (PCS) causes chronic heel pain due to bony outgrowth.
- Haglund's deformity involves a calcaneal enlargement impinging the Achilles tendon.
- The association between PCS and Haglund's deformity is not well-established.
Purpose of the Study:
- To evaluate the relationship between PCS and Haglund's deformity.
- Determine the incidence of Haglund's deformity in symptomatic PCS patients.
- Investigate associated factors for this co-occurrence.
Main Methods:
- Retrospective case-control study of 377 adult patients.
- Weight-bearing lateral foot radiographs analyzed.
- Haglund's deformity assessed using the BRINK angle (>20°).
Main Results:
- Haglund's deformity was significantly more prevalent in the PCS group (66.0%) versus controls (18.7%).
- Diabetes mellitus was associated with Haglund's deformity.
- No significant differences in age, sex, or BMI were found.
Conclusions:
- A strong radiological association exists between PCS and Haglund's deformity.
- Shared biomechanical stress pathways likely link the plantar fascia and Achilles tendon.
- Further research is needed to clarify mechanisms and clinical implications.
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