Other Soft Tissue Pain Conditions

This study was a retrospective review of X-rays of a single surgeon’s patients with insertional Achilles tendinitis from 2005 to 2008. The study population consisted of 44 patients [48 heels]. There were 22 males and 22 females. They all had insertional Achilles tendinitis. They had a mean range of 52 years. The control population consisted of 50 patients [25 males, 25 females] and 50 heels without insertional Achilles tendinitis. The mean age of the control group was 55.6 years. Two measures of the Haglund’s deformity were made in the study. A standing lateral foot or ankle radiograph was analyzed for each patient and measurements were made. Haglund’s deformity height and peak angle, Buhler’s angle, Fowler–Phillip angle, and parallel pitch sign were measured. The office also looked for presence of calcifications in the study group and the length and width of the calcifications. Unpaired t-tests were used to analyze the measurements between the groups. In order to check the reliability of the measuring techniques, 10 patients’ radiographs were remeasured and correlation coefficients were obtained. In the group which had Achilles tendinitis, the mean Haglund’s deformity height was 96 mm and the mean Haglund’s deformity peak angle was 105 degrees. Calcification was present in 35 of 48 of the patients, [73%] with a mean length of 13.3 mm and a mean width of 4.5 mm. In the control group, the mean Haglund’s deformity height was 9.0 mm and the peak angle was 105 degrees. Buhler’s angle and Fowler–Phillip angle were also similar between the groups and the positive parallel pitch sign was more prevalent in the control group [60 versus 42%]. None of the differences in measurements between the two groups achieved statistical significance. The authors concluded that Haglund’s deformity was not indicative of insertional Achilles tendinitis and was actually present in asymptomatic patients. The further concluded that removing the Haglund’s deformity may not be necessary in the operative treatment of insertional Achilles tendinitis.