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Achilles tendon ossification

Case contributed by Hein Els
Diagnosis almost certain

Presentation

Had club foot as a child. Now presents with foot pain. Impingement questioned.

Patient Data

Age: 60 years
Gender: Male
x-ray

Thickening and ossification of the Achilles tendon. Haglund deformity. Plantar calcaneal spur. Subchondral cysts at the calcaneo-cuboid joint. 

No osseous impingement at the ankle. Subchondral lucency at the talar dome in keeping with the Hawkin sign, likely from disuse osteopenia or local hyperemia in this case.  Small volume ankle joint effusion. Degenerative changes at the middle and anterior subtalar, talonavicular and proximal intertarsal joints. Subluxation of the talonavicular joint. Ossification of the Achilles tendon. Haglund deformity of the calcaneus. Plantar calcaneal spur.

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