Podiatric Medicine and the Painful Heel
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Infracalcaneal heel pain (heel spur syndrome) can occur if plantar fasciitis progresses and microtears of the proximal fascia occur at the attachment areas to the heel. Low-grade periostitis occurs along with thickening in the area of trauma. Edema and fibroblastic inflammatory cell infiltration can also occur. Periosteal calcification occurs near fascial and tendonous attachments. The infracalcaneal heel spur forms in this manner (Figure 15.4). A “traction” type of spur from excessive pulling of the soft tissue is noted on lateral radiograph of the foot.
The ankle and foot
David Silver in Silver's Joint and Soft Tissue Injection, 2018
Plantar fasciitis. This painful heel condition is characterised by an acutely tender spot in the middle of the heel pad on standing or walking. There is often a calcaneal spur demonstrated on a radiograph of the heel. This condition may occur in the seronegative arthropathies and should be suspected if the radiograph also demonstrates erosions or a fluffy or irregular calcaneal spur.
Comparison between radial and focused types of extracorporeal shock-wave therapy in plantar calcaneal spur: A randomized sham-controlled trial
Published in The Physician and Sportsmedicine, 2023
Volkan Şah, Şeyhmus Kaplan, Sezai Özkan, Cihan Adanaş, Murat Toprak
Plantar calcaneal spur (PCS), an abnormal bony outgrowth arising from the calcaneal tuberosity, is a common disorder associated with heel pain [1,2]. Its prevalence in the young to middle-aged subjects varies between 11% and 21% across various ethnicities, but increases significantly with aging and in the presence of heel pain and osteoarthritis, up to 55–81% [1]. In addition, obesity, degraded foot biomechanics such as pes planus and foot pronation, repetitive trauma and sport activities, degenerative processes, and inflammatory disorders are risk factors for PCS formation [1,2]. Although there is no standard therapy for PCS, non-surgical treatments, such as nonsteroidal anti-inflammatory medication, local injection of corticosteroids, extracorporeal shock waves, heel pads, stretching exercises, and physical therapy are usually applied. Considering that old and obesity rates will be even higher in the future, PCS also may be a bigger problem.
Tumour necrosis factor inhibitors in enthesitis related arthritis and juvenile spondylarthropathies
Published in Expert Opinion on Orphan Drugs, 2018
Sonographic examination of the joints, effusion, synovial hyperplasia, and increased power Doppler signals can be detected. In some children, the enthesitis can only be detected by the ultrasound and power Doppler examination or magnetic resonance imaging (MRI) but not clinically [14,15]. Especially in the diagnosis of active sacroiliitis, MRI is the method of choice because of radiation exposure in children. The current gold standard in adults and children is the MRI with Short Tau Inversion Recovery (STIR) [16]. STIR sequences without gadolinium can be sufficient for a diagnosis of sacroiliitis [17]. Conventional X-ray diagnostics can detect destruction, ankylosis, and calcifications (heel spur). It is not suitable for early diagnosis of sacroiliitis in children or adolescents.
Cross-cultural adaptation, reliability and validity of the Persian version of the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A)
Published in Disability and Rehabilitation, 2022
Milad Bahari, Mohammad Hadadi, Amir Reza Vosoughi, Amin Kordi Yoosefinejad, Sobhan Sobhani
For assessing the psychometric properties of VISA-A-P, convenient sampling was performed among patients referring to an outpatient orthopedic clinic affiliated to Shiraz University of Medical Sciences. Sixty-one patients with the diagnosis of Achilles tendinopathy were recruited after a clinical examination performed by a foot and ankle orthopedic surgeon. Diagnostic criteria of the study were based on Maffulli et al. [37] study and considering history, physical examination and plain film radiologic assessment. Moreover, standing ankle radiographs were requested to assess any deposited intratendinous calcification and ossification (posterior heel spur).