Haglund's Exostosis

Haglund's exostosis is a bony growth on the back of the heel bone in front of the Achilles tendon attachment, which is a common cause of back heel pain. It occurs during chronic mechanical irritation (e.g. sports, tight shoes) and can lead to inflammation of the surrounding soft tissues.

Etiology
The cause of Haglund's exostosis is the influence of "long-term mechanical irritation", most often wearing "inappropriate shoes", which causes pressure from the upper edge of the heel. Developmental variation in the shape of the heel bone, trauma and sports overload can also contribute to this.

Clinical picture


Manifestation of exostosis is on the back of the heel when walking in a shoe. On physical examination, the area behind the insertion of the Achilles tendon is palpable and swollen.

In the initial stages, no changes are visible on X-ray. Later, bony apposition occurs, which appears as a bony growth above the tuber calcanei on the radiograph.

Therapy
Treatment of exostosis can be divided into conservative and surgical.

Conservative treatment counts in ``relieving the painful area'' by adjusting the shoes. This change can be made, for example, by inserting a heel so that the swelling goes above the edge of the heel. Physical treatment (laser, x-ray therapy) is also suitable.

Operative treatment consists in ablation of the exostosis on the tuber calcanei.

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