A STUDY ON THE CLINICAL AND RADIOLOGICAL CORRELATION BETWEEN POSTERIOR HEEL PAIN AND SEVERITY OF HAGLUND’S DEFORMITY

Abstract

Haglund's deformity is often associated with posterior heel pain, and the link between the morphology of the heel and severity of the condition is not yet clear. This study evaluated the correlation between the radiologic features and the patients' symptoms and the short-term changes in symptoms. The study was a prospective observational study with 62 adults with a symptomatic Haglund's deformity. Lateral radiographs were evaluated for Böhler's angle, Fowler–Philip angle, deformity height, deformity peak angle and calcaneal pitch. A modified 5-item clinical questionnaire was used to document the clinical status at presentation and at the end of 3 months of conservative treatment. A correlation of radiographic parameters with clinical scores was attempted at every visit. Baseline correlations were weak and nonsignificant (r = −0.128 to −0.061; all p > 0.05). Correlations were not significant at three months (r = −0.130 to 0.003; all p > 0.05). Mean clinical scores increased from 29.91 ± 6.04 to 38.51 ± 5.22, a descriptive difference of 8.60 points. There was no estimation for this observed change. In this group, there was no significant correlation between the conventional radiographic measurements and clinical status. Imaging should be used in conjunction with symptoms. Studies are needed with validated clinical outcome measures and longitudinal analysis that would allow identification of baseline morphologic predictors of clinical improvement.