Abstract:The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. Historically, authors have described the intrinsic muscles of the foot and/or the plantar fascia as attaching to the PCS. In this article we review the relationship… Show more
“…The majority of plantar calcaneal spurs arise from the medial process of the tuberosity. 3 Plantar heel pain is the most prevalent complaint causing patients to present to foot and ankle specialists. In nearly all cases in the literature, the mechanism of injury was a fall down stairs, an injury while swimming at a local pool, attack by a monkey, and accidentally slipping.…”
Heel pain is a complaint frequently encountered in orthopedic clinics that has peculiar symptoms and may have various etiologic causes. Calcaneal spur fracture is an extremely rare cause of heel pain, and only four cases had previously been reported in the English language literature. We present a 45-year-old woman who had heel pain on her right foot after falling from a height onto the heel. Radiographic examination of her right foot showed a fractured calcaneal spur, which was successfully treated with conservative methods. Calcaneal heel pain is a complaint that may be attributable to many different etiologic causes, which often have specific symptoms, and we frequently encounter them in the orthopedic clinic. Calcaneal spur fracture after trauma should be remembered in the differential diagnosis of heel pain as a rare cause. Our case is the fifth reported case in the English language literature of this extremely rare condition.
“…The majority of plantar calcaneal spurs arise from the medial process of the tuberosity. 3 Plantar heel pain is the most prevalent complaint causing patients to present to foot and ankle specialists. In nearly all cases in the literature, the mechanism of injury was a fall down stairs, an injury while swimming at a local pool, attack by a monkey, and accidentally slipping.…”
Heel pain is a complaint frequently encountered in orthopedic clinics that has peculiar symptoms and may have various etiologic causes. Calcaneal spur fracture is an extremely rare cause of heel pain, and only four cases had previously been reported in the English language literature. We present a 45-year-old woman who had heel pain on her right foot after falling from a height onto the heel. Radiographic examination of her right foot showed a fractured calcaneal spur, which was successfully treated with conservative methods. Calcaneal heel pain is a complaint that may be attributable to many different etiologic causes, which often have specific symptoms, and we frequently encounter them in the orthopedic clinic. Calcaneal spur fracture after trauma should be remembered in the differential diagnosis of heel pain as a rare cause. Our case is the fifth reported case in the English language literature of this extremely rare condition.
“…It has also been proposed to be a part of the normal degenerative process with a general tendency toward ossification of ligaments . Although a subpopulation of those with plantar calcaneal spur are completely asymptomatic, the relationship between plantar calcaneal spur and painful heels has been shown by multiple studies . These subplantar spurs from degenerative or mechanical causes have been differentiated from those of systemic inflammatory disorders as subplantar irregular spurs .…”
Among simple radiographic alterations on heels with AS, such changes around the enthesis of the Achilles as bony erosion and RR obliteration with swollen posterior soft tissue are strongly related to current painful posterior heels. Assessment of enthesitis of the Achilles tendon in AS using plain radiography seems to be valid.
“…Several systemic conditions are associated with enthesophytes, including psoriatic arthritis , rheumatoid arthritis , and diffuse idiopathic skeletal hyperostosis . However, enthesophytes may also develop in response to local mechanical stresses , and their prevalence, particularly at the foot, increases with age and body mass index .Calcaneal enthesophytes are associated with foot osteoarthritis (OA) but not hand OA.Patterns of association are similar for osteophytes and joint space narrowing.These findings suggest that calcaneal enthesophytes represent a local, biomechanical rather than systemic bone‐forming process.…”
Objective
To examine associations between calcaneal enthesophytes and osteoarthritis (OA) in the hands and feet, and to provide insights into the role of biomechanical and systemic processes in the development of OA.
Methods
Adults ages ≥50 years who were registered with 4 general practices were mailed a Health Survey. Responders reporting foot pain within the last 12 months underwent a detailed assessment, including hand and foot radiographs. Calcaneal enthesophytes (plantar and posterior) and OA features (osteophytes and joint space narrowing) were documented. Associations between enthesophytes and hand and foot OA (including OA phenotypes and OA features at individual joints) were explored using generalized estimating equations, adjusting for age, sex, and body mass index.
Results
Data were available from 532 participants (298 women, mean ± SD age 64.9 ± 8.4 years). Calcaneal enthesophytes were not associated with hand OA phenotypes or OA at individual hand joints. In contrast, plantar calcaneal enthesophytes were positively associated with polyarticular foot OA (odds ratio [OR] 1.80 [95% confidence interval (95% CI) 1.02–3.17]). When individual foot joints were examined, posterior enthesophytes were associated with talonavicular joint OA (OR 1.58 [95% CI 1.02–2.44]) and plantar enthesophytes were associated with first metatarsophalangeal joint OA (OR 0.67 [95% CI 0.49–0.98]) and navicular‐cuneiform joint OA (OR 2.30 [95% CI 1.40–3.79]). Patterns of association were similar for osteophytes and joint space narrowing.
Conclusion
Calcaneal enthesophytes are associated with foot OA but not hand OA. The pattern of association is indicative of a local, biomechanical rather than systemic bone‐forming process.
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