The ankle joint (or talocrural joint) is a synovial joint located in the lower limb. It is formed by the bones of the leg and the foot – the tibia, fibula and talus. Functionally, it is a hinge type joint, permitting dorsiflexion and plantarflexion of the foot.
Haglund’s deformity can cause pain at the back of the heel increasing during strain. You may see reddening and swellings at the heel, which may be very sensitive to pressure. Because Haglund’s disease is an ossification at the base of the Achilles tendon, it can also influence the Achilles tendon. In this case, pain may emerge if the foot is raised to the shin or while squatting and then standing up (plantar flexion). Most people have problems with normal footgear because the heel of the shoe is too narrow or the top edge too low.
Symptoms of Haglund’s deformity in short:
Pain subject to strain
Reddening and swelling of the heel
The heel is sensitive to pressure
Pain while raising the foot to the shin
Normal footgear is often not tolerated anymore
The Haglund’s deformity is a congenital variation of the heel. If the heel is strained, the often pointy ossification exerts pressure on the heel and the Achilles tendon. The periosteum (membrane surrounding bones) is irritated and the Achilles tendon may be roughened or worn down. It is also possible that the bursa inflames that is between the heel and the Achilles tendon. Pressure is often also exerted by normal footgear that presses on Haglund’s deformity due to too narrow heel or too low top of the shoe. This strain is increased under strain and especially while standing up from a crouching position or raising the foot to the shin.
In case of an assumed Haglund’s disease, a comprehensive orthopedic examination is carried out often accompanied by imaging procedures like X-raying or MRI. The existence of Haglund’s deformity can be proven by X-raying.
Os Trigonum Syndrome
The os trigonum is a small additional bone that is located on the backside of the ankle at the talus bone. According to estimations, 3-15 % of adults have an os trigonum that may cause several symptoms.
Patients suffering from os trigonum syndrome can feel pain in the backside of the ankle often accompanied by swellings. Generally, it is a permanent pain that worsens significantly when straining the ankle. Besides these symptoms, os trigonum syndrome may also cause stiffness and weakness in the ankle.
Symptoms of os trigonum syndrome in short:
Pain in the back of the ankle
Swelling of the ankle
Permanent pain increasing when straining the ankle
Stiffness and weakness of the ankle
The existence of the os trigonum is congenital, but does not necessarily lead to the os trigonum syndrome. The syndrome may emerge if the foot is repeatedly strained, for example, due point positions during toe-dance in ballet, supporting or pushing off the feet while climbing or kicking the ball using the arch of the foot during soccer, football or rugby. The os trigonum syndrome can also become a chronic disease.
In case of an assumed os trigonum syndrome, a comprehensive orthopedic examination is carried out often accompanied by imaging procedures X-raying or MRI. The existence of the os trigonum can be proven by X-ray.
The best method to differentiate between different injuries is MRI. MRI enables us to visualize very different structures during one examination like muscles, ligaments, tendons, cartilage, and bones. If it is necessary, we do also apply a well-tolerated contrast agent to improve the visibility of certain structures.