43F with more impressive looking PTT tenosynovitis and tendinosis, but only
complaints in the Achilles region.
There is mild insertional tendinosis without tear and mild edema of the
peritenon and minimal retrocalcaneal bursal inflammation.
My question is about the edema like signal along the posterior calcaneum.
Is this “enthesitis”? Almost looks like apophysitis…except that she’s
all grown up!
[image: Consult Heel 43F.jpg]
[image: Consult Heel 43F (1).jpg]
[image: Consult Heel 43F (2).jpg]
[image: Consult Heel 43F (3).jpg]
As I reported this, I realized there is marrow edema extending into the
posterior calcaneus.
Hemang mentioned insertional tendinosis (which I acknowledged, though it
seems relatively mild, with more inflammation of the peritenon).
I thought the edema at the posterior calcaneus is out of proportion to the
Achilles tendinosis…
I wonder if this is stress reaction without fracture.
I know we sometimes see this appearance in the anterior patella…I just
don’t recall seeing this pattern—-but, if this were a kid, I would
definitely call it apophysitis.
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