Association of Achilles Tendinopathy and Plantar Spurs

NewsBot · Oct 4, 2014

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Association of Achilles Tendinopathy and Plantar Spurs.
Vulcano E, Mani S, Do H, Bohne WH, Ellis SJ.
Orthopedics. 2014 Sep 1;37(10)

Plantar spurs and Achilles tendinopathy are common causes of heel pain. In the authors' practice, it was anecdotally noted that patients with Achilles tendinopathy often presented with plantar spurs. Nonetheless, there is a shortage of studies investigating whether Achilles tendinopathy and plantar spurs exist concomitantly. A better understanding of the association between the 2 pathologies might help physicians recognize and treat both conditions, educate patients about Achilles tendinopathy and plantar spurs, and ultimately investigate possible underlying causes of both pathologies that could be addressed together. The authors examined the prevalence of plantar spurs in patients diagnosed with Achilles tendinopathy as well as demographic differences within the unilateral and bilateral Achilles tendinopathy populations. A total of 785 patient records were retrospectively reviewed. Mean patient age was 56.2±15.5 years (46.9% men and 53.1% women). Seventy-two (9.2%) patients were affected bilaterally by Achilles tendinopathy. Lateral radiographs were reviewed by an orthopedic surgeon to identify the presence of plantar spurs. A total of 329 (41.9%) patients with Achilles tendinopathy were found to have a concomitant plantar spur. Patients with unilateral Achilles tendinopathy and a plantar spur were more likely to be women (58.7% vs 49.8%, P=.020) and older (62.7 vs 51.7 years, P<.001). In the bilateral Achilles tendinopathy group, there were 46 (63.9%) patients with at least one foot presenting with a plantar spur. The study's findings suggest a significant association between Achilles tendinopathy and plantar spurs. Older women with Achilles tendinopathy are at greater risk of being affected by plantar spurs.
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Admin2 · Oct 4, 2014

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NewsBot · Oct 10, 2014

A study of calcaneal enthesophytes (spurs) in Indian population.
Kullar JS, Randhawa GK, Kullar KK.
Int J Appl Basic Med Res. 2014 Sep;4(Suppl 1)

INTRODUCTION:
Calcaneus or os calcis forms a major component of the skeleton of foot providing posterior pillars for bony arches of the foot. It is largest of seven tarsal bones of foot and forms prominence of heel. Many times anterior to calcaneal tuberosity an osteophytic outgrowth has been observed (calcaneal or heel spur) extending along entire width, for about 2-2.5 cm. The apex of spur seen embedded in plantar fascia, directly anterior to its origin. Hence, the study of calcaneal spurs has been undertaken.
MATERIALS AND METHODS:
The material for the study consisted of 200 dry (100 right and 100 left), adult calcanei of unknown age and sex obtained from Department of Anatomy. The calcaneal enthesophytes/spurs were studied in detail and classified according to types of calcaneum.
RESULTS:
Maximum incidence of calcaneal spurs were found in Type I calcanei (11%) and no calcaneal spurs were found in Type III calcanei. Total incidence of dorsal calcaneal spurs in all types of calcanei was maximal (15.5%). The incidence of plantar spurs was 6.5% being highest in Type I calcanei (4%). The incidence and type of calcaneal spurs were compared with those of previous studies and etiology of heel pain has been discussed. Correlation between type of calcanei and spurs has been studied for the 1(st) time.
CONCLUSION:
Calcaneal spurs are related to type of calcanei with the highest frequency in Type I and least in Type III (no spurs seen in Type III and least in Type IV). Other factors, which contribute toward increase in incidence of spurs, are increasing age and weight, concurrent orthopedic diseases, and heel pain.
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Dananberg · Oct 11, 2014

Seems to me that this was more a symptom that cause review. Looking at the stresses when they walk would be far more interesting, as this would seem far more likely to be the cause of both, vs. viewing these two issues as being independent of each other.

In the early 90's, my podiatry business partner at the time was dealing with a metastatic osseous malignancy. A lesion developed in his L clavicle. He had a 2" segment of his collar bone removed, and when his L shoulder "let go" while picking up his son, his orthopedic surgeon told him that there was no relationship! How foolish. It gave me some very interesting insight to an orthopedic model of body mechanics.

Howard

NewsBot · Nov 2, 2014

Changes in prevalence of calcaneal spurs in men & women: a random population from a trauma clinic.
Toumi H, Davies R, Mazor M, Coursier R, Best TM, Jennane R, Lespessailles E.
BMC Musculoskelet Disord. 2014 Mar 15;15:87. doi: 10.1186/1471-2474-15-87.

BACKGROUND:
This study reports the changing prevalence of ankle (Achilles and plantar) spurs with age, in order to comment on their significance to rheumatologists.
METHODS:
1080 lateral ankle radiographs from each of 9 (50 men and 50 women) age cohorts from 2 to 96 years old of patients attending a trauma clinic were examined and spurs classified as small or large.
RESULTS:
The prevalence of both Achilles and plantar spurs in relation to the age categories and sex was variable. Overall, there was 38% of the population who had a spur (Achilles or plantar) and only third (11%) with spurs at both sites (Achilles and plantar). Large spurs were more prevalent in older individuals (40 to 79 years). There were no large plantar spurs in individuals <40 years of age and only 2% for the Achilles. The prevalence of spurs (Achilles and plantar) was significantly higher for woman than men in individuals <50 years of age. There was a notable moderate positive correlation (r = 0.71) between both plantar and Achilles spurs for women <30 years of age but no correlation for men (r = -0.03).
CONCLUSION:
Plantar and Achilles spurs are highly prevalent in older people and the radiographic appearance of spurs differs between men and women. In individuals < 50 years of age, spur (Achilles and plantar) formation is more common in women than in men. Additionally, there was a notable moderate positive correlation between Achilles and plantar spurs for women <30 years of age.
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