THE CORRELATION BETWEEN ABNORMAL CALCANEAL MORPHOLOGY AND CALCANEAL SPURS IN ACHILLES TENDINITIS AND PLANTAR FASCIITIS – AN OBSERVATIONAL STUDY

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Background Plantar heel discomfort is often connected with plantar fasciitis, whereas posterior heel pain is typically related to insertional Achilles tendinitis. This study seeks to illustrate the correlation between atypical calcaneal shape and the existence of calcaneal spurs indicative of various tendinopathies. Methods A prospective observational research was conducted for patients exhibiting heel pain suspected of insertional Achilles tendinitis or plantar fasciitis at SRM MCH Department of Orthopaedic. Standing lateral and axial radiographs were assessed for the Fowler-Philip Angle (FPA), calcaneal width, and Parallel Pitch Lines (PPL). The existence of posterior and plantar calcaneal spurs were associated with these morphological characteristics. Results Patients with posterior spur demonstrated a greater mean FPA (68.31°) than those without the spur (66.11°), along with an increased calcaneal width (40.63 mm vs. 39.59 mm). Abnormal PPLs were markedly more common in patients with posterior spur (56.3%) and plantar spur (48.1%) than in those without spurs (23.1% and 29.2%, respectively). A composite prediction model produced an Area Under the Curve (AUC) of 0.72 for the development of posterior spurs. Conclusion A clinically significant correlation exists between aberrant calcaneal morphology and the occurrence of both posterior and plantar calcaneal spurs. Abnormal PPLs, particularly when associated with increased calcaneal width and elevated FPA, are significant radiographic markers of heel pain disorders.