Anatomy of the heel bone x-ray

Sometimes an X-ray of the heel and a symptom-free foot is taken. This is necessary in order to compare the bones of the affected and healthy leg when the doctor has doubts about the diagnosis.

Sever's disease

Sever's disease is an abusive syndrome that occurs primarily in young athletes who compete in jumping and running. Other names are heel bone inflammation or Osgood-Schlatter foot syndrome. The disease was first described by James Warren North in 1912. The problem is related to the constant occurrence of micro-trauma from traction on the Achilles tendon. Traction of the tendon occurs at the secondary ossification center of the heel bone, resulting in damage to its apophysis. The cause of this traction apophysitis is repeated micro-injuries or overuse of the heel by young athletes.

The heel bone is located at the back, plantar part of the foot. The Achilles tendon attaches at the bottom, behind, and about midway through the heel bone. The plantar fascia begins at the medial tuberosity in the plantar area of the heel bone. Closer to the epiphysis is the apophysis, around which the Achilles tendon actually wraps. The growth area of the heel bone and its apophysis are heavily loaded by the plantar fascia and Achilles tendon. In addition, the different growth rates of muscle and bone can lead to a shortening of the tibialis triceps muscle, which can result in less cushioning between the foot and the surface. In addition, the Achilles tendon has a relatively wide insertion area that is anatomically connected to the plantar fascia. This actually helps prevent traumatic rupture of the ossification center.

Epidemiology/Etiology

Sever's disease is an osteochondrosis caused by excessive stress on the heel bone insertion site of the Achilles tendon and the growth plate of the epicondyle. This growth area is C-shaped and can become inflamed if the Achilles tendon is repeatedly pulled. Heel epiphysis inflammation commonly affects young athletes and is believed to be caused by running and jumping.

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Serious foot disorders are most common in active children and adolescents aged 7-15 years. It occurs particularly frequently during the pubertal growth spurt or at the beginning of the sports season in gymnasts, basketball and soccer players. The disease usually occurs at the beginning of the growing season. Boys are affected more often (ratio 2-3:1).

None of these etiological factors have been prospectively studied. In addition, the available studies have not been conducted systematically, so the reliability or validity of the measurements has not been adequately investigated.

What is a heel bone x-ray?

Of all the bones in the foot, the heel bone is the largest. When walking, running and jumping, it is heavily used, which leads to increased injuries. An X-ray can provide information about the severity of the heel injury, whether there is a fracture, and what type of fracture it is (with or without a dislocation).

Another common problem is heel spurs. It is caused by wearing improper footwear, arthritis or osteoarthritis, but most commonly flat feet. If left untreated, it can lead to complications such as bunions (plantar fasciitis) and fasciitis (inflammation of the foot muscles). The main method of diagnosing these anomalies is X-ray examination, which today can be performed in almost any public or private clinic.

Indications for a heel radiograph

Consider the cases in which a heel x-ray may be recommended:

• Trauma to the foot in the heel area. The causes are different: work trauma, sports injury, fracture as a result of a traffic accident, etc.
• Severe pain in the heel area. Usually occurs in the morning or after a nap when getting up after a short rest and leaning on the heel.
• Pain in the heel area when walking.
• Altered gait (shifting the body's center of gravity to the toes).
• Suspected joint disease – arthritis, osteoarthritis.
• Suspected inflammatory bone disease – osteomyelitis, etc.
• Suspected malignant and benign bone and joint tumors.

What does an X-ray examination of the heel bone show?

X-rays are initially used to assess the integrity of the heel bone. Then its shape and position in relation to the other bones of the foot are analyzed. If heel fractures are detected, their location and direction are examined. If it is a fragment fracture, it is necessary to assess how the fragments are positioned and whether they are displaced.

Tumors on the heel bone can be shown quite well on the x-ray. In this case, the size and location of the tumor must be assessed in order to infer the nature of the abnormality.

IMAGES OF THE HEEL BONE

The aim of the imaging examinations is to examine the shape and structure of the heel bone in various diseases and injuries

Positioning the patient for imaging. X-ray of the heel bone is performed in lateral and axial projection.

A lateral view of the calcaneus is most often obtained from a lateral view of the foot, but sometimes the same patient is placed in the same position to obtain a focused image of the calcaneus by appropriately collimating the X-ray beam to the center of the calcaneus (Figure 451) .

The position for taking an axial radiograph of the heel bone is as follows. The patient lies on his back and stretches out both legs. The foot of the limb in question is in maximum dorsiflexion (Figure 452, a). Sometimes it is withdrawn dorsally with a bandage thrown over the foot, which the patient is holding.

The 13 x 18 cm cassette is laid lengthwise on the table. The foot rests on it with the back of the heel.

The central X-ray beam is cut cranially at an angle of 35-45° to the vertical and directed to the calcaneus tubercle.

The exposure can also be taken with the patient in an upright position. The patient places the soles of the feet of the limb to be removed on the cassette surface, stepping the leg back so that the tibia is at an angle of approximately 45° to the plane of the cassette. The patient should lean against the backrest of a chair in front of them to stabilize their body.

The X-ray beam is aimed at the posterior aspect of the calcaneus tuberosity at an angle of 20° to the vertical (Fig. 452b).

meaningfulness of the images. The lateral projection radiograph shows the structure and contours of the calcaneus and talus (Fig. 453).

The axial view shows the tubercle of the calcaneus and its medial and lateral surfaces (Fig. 454). These images are useful for detecting various pathological changes, fractures, heel spurs (Fig. 455), changes in bone structure, especially after trauma (Fig. 456), etc.

HEEL PICTURES

Determination of the scans. Images of the toes are most commonly used for trauma.

Positioning the patient for X-rays. The toes are clearly visible on straight and oblique x-rays of the foot. If necessary, target images of the toes are taken in the same projections, with the X-ray beam appropriately narrowed and centered on the toe area (Fig. 457, a).

In some cases, x-rays of the fingers are taken from the side by placing a 4 x 5 cm film wrapped in opaque paper under the affected finger. For X-rays of fingers I and V, the foot is placed on the lateral and medial surfaces, respectively, and the X-ray beam is centered perpendicular to the finger in question. When radiographing the fingers I , IIII and IV, the above fingers are pulled down or up with a bandage so that their image does not overlap with the toe joints of the examined finger (Fig. 457, b).

A direct radiograph of the toes clearly shows the phalanges, partially the metatarsals, and the interphalangeal and metatarsophalangeal joints (Fig. 458).

Tags: foot
234567 Start of activity (date): 30.12.2019 18:33:00
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234567 Keywords: foot, x-ray image, tarsal bone, metatarsal bone, toe bone.
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How is the investigation carried out?

The examination does not require any special preparation and can be carried out for both acute and elective indications. The area to be examined must be free of any metal objects.

The procedure takes 10 minutes.

X-ray of the heel bone can be done in two ways:

• Straight X-ray - patient is supine with legs bent and soles of feet on table;
• X-ray with weight – the patient stands on the leg being examined and transfers his body weight to the foot.

X-rays of the heel bone are taken in the straight and/or lateral projection.

Prices for the services You can take a look at the price list or call the phone number on the website for details.

The information on this website should not be used for self-medication and self-diagnosis. In the case of acute illnesses, diagnostic tests should only be carried out by a doctor! In order to make a correct diagnosis and prescribe treatment, you should contact your doctor.

Prices for X-rays of the heel bone

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• Open

causes

A calcaneus fracture usually results from catatrauma, which is a fall of the body from a height where the feet are resting. In some cases, the bone can also be damaged by a shock wave. In older patients, who show an age-related decrease in bone mineral density, heel fractures can occur even with slight mechanical pressure, such as twisting the foot.

These injuries are called pathologic fractures (resulting from osteoporosis).

Why SM Clinic?

Diagnosis is based on objective examination and an X-ray. From the x-ray, we can clearly see what a traumatic bone injury looks like, where the bone fragments are directed, and what other characteristics the injury has.

In complex clinical cases, CT scans can help make the diagnosis and identify reliable fracture symptoms. With this method, the images are taken layer by layer with minimal increments, allowing the doctor to determine the condition of the tissue in detail.

indications

The main reason for prescribing this test is pain in the foot. The pain occurs most frequently during exertion (e.g. when walking). The patient turns to the doctor who diagnoses plantar fasciitis, a degenerative bone lesion in the heel area caused by stress and overuse. This pathology leads to a compensatory reaction of bone tissue, which leads to the formation of bone outgrowths called osteophytes. This pathology is called heel spurs. It puts increased pressure on the soft tissues of the foot, causing cracks and inflammation in the foot. 'Heel spurs can develop chronic and progressive inflammation of the ligaments and tendons and also damage the muscles around the foot.

Heel spurs mostly occur in middle-aged and elderly people. It also occurs in people who are overweight, have ankle problems, flat feet, or arthritis. He also appears in athletes.

Another common reason for a heel bone x-ray is trauma to the foot. A sharp and violent blow to the foot area can damage the bone - a fracture can occur. Tissue swelling and pain syndromes are noted as a result of torn ligaments and muscles accompanying bone damage.

In the treatment of heel spurs, various physiotherapeutic and instrumental treatments are used to eliminate inflammation of soft tissues:

1. Cushions and insoles to relieve pressure on the heel when walking
2. Massages, mud and heat treatments
3. Ultrasound, laser, shock wave therapy
4. Local injection of anti-inflammatory drugs.

X-ray therapy has also proven effective for heel spurs.

To have your heel X-ray in Kiev, but also for other extensive examinations, you can always contact the Meddiagnostika clinic. The clinic has the most modern technical equipment in the form of a digital X-ray machine made in Japan with the possibility of printing the images on tape and storing them on disk for subsequent discussion with a specialist inside and outside the clinic.

Contraindications and limitations

The radiograph of the heel bone is the most important diagnostic tool to establish the diagnosis. It is recommended regardless of the age and gender of the patient.

X-rays of the heels are not recommended for pregnant women without urgent indications (trauma), as it can adversely affect the health of the fetus and the woman herself. In any case, the effects of ionizing radiation are minimized by using special personal protective equipment (aprons, collars, gonad protectors) with which the X-ray laboratory is equipped. When x-raying the heel bone, the x-ray machine has the ability to adjust the radiation field so that the examination area is hit exactly without affecting the rest of the body. The X-ray machine itself also has settings for adults and children.

Indications for X-ray examination of the heel

Due to its special anatomical structure and high daily loads, the heel bone is subject to frequent trauma and pathological processes. An X-ray of the heel is the easiest, fastest and most meaningful way to detect anomalies in time.

An X-ray should be ordered if the following symptoms appear:

• burning or severe pain in the heel
• Restriction of joint mobility in the foot
• pain and discomfort when walking
• Changes in gait, shifting the center of gravity from the heel to the toes
• Swelling, redness and local temperature increase in the area of the heel bone protrusion.

X-rays are taken after trauma to the foot when fractures, breaks, or dislocations are suspected. With bony hypertrophy in the heel area, the diagnostician can assess the development of a spur. X-rays help the doctor assess the effectiveness of treatment for inflammatory diseases, identify the features of bone fusion in fractures, and understand the causes of chronic pain.

Diagnostic X-rays are required if there is a suspicion of:

• osteoporosis
• flat feet
• osteitis
• Achilles tendon rupture and heel bone dislocation
• Arthritis, arthrosis, osteochondropathy.

X-ray shows signs of inflammation characteristic of plantar bursitis, plantar fasciitis, and tendinitis. When describing the x-ray, attention is paid to the integrity of the bony structures, the shape of the heel shaft and its position in relation to the rest of the tarsal area. If abnormalities are found, additional investigations, including examining the other foot, may be needed to make an accurate diagnosis.

Preparing for surgery

X-ray examination of the heel bone for fracture, spur or inflammation is performed without preparation. A referral for the examination may be issued by an orthopedist/traumatologist, podiatrist, rheumatologist, or surgeon. It is advisable to bring the results of previous examinations so that the radiologist can follow the progression of the pathological process.

Immediately before the examination, the specialist will ask you to take off your shoes and free your foot from socks, jewelry and foreign objects.

Contraindications to radiographs of the heel bone

Relative contraindications include pregnancy, lactation and children under 15 years old. Patients in this category are only examined if there is a corresponding indication and after a possible risk has been assessed.

Causes of heel bone fractures

A heel bone fracture is usually caused by a sudden or very strong impact. The severity of the fracture depends on the force of the impact. Some common causes of fractures:

Patients with brittle bones have a higher risk of suffering a heel bone fracture. Bone density may decrease due to the following factors:

• aging
• osteoporosis
• endocrine or intestinal disorders
• corticosteroid treatment
• Lack of regular physical activity
• alcohol and tobacco abuse.

CT or X-ray for a heel fracture - which is better?

CT scans and X-rays are the two main methods used to diagnose injuries to the bony structures of the heel. X-rays provide a very accurate assessment of bone condition and are therefore the preferred form of diagnosis for heel bone fractures. Other benefits of CT and X-rays in fracture diagnosis include:

• The duration of the procedure is only 2-3 minutes;
• an accurate examination without surgical intervention;
• no inconvenience during the examination
• no prerequisites for the patient;
• quick availability of test results.

For these reasons, CT and X-ray are the preferred forms of examination in emergency situations when a surgeon or trauma surgeon needs to act quickly.

Compared to an X-ray, a CT scan of the heel is more detailed and accurate. From a diagnostic point of view, the CT examination has a number of advantages:

• provides a clear and three-dimensional image of the bone;
• three-dimensional bone models can be created;
• the results are immediately visible during the examination;
• The physician can assess both the bony structures and the adjacent soft tissue structures of the limb without the tissue images overlapping.

• Anatomy of the foot x-ray.
• Anatomy of the heel bone.
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• X-ray anatomy of the ankle.
• Heel bone human anatomy photo and description.
• How Much Does an Orthopedic Surgeon Make?.
• heel bone flexion angle.