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Haglund syndrome is a common cause of posterior heel pain, characterized clinically by a painful soft-tissue swelling at the level of the achilles tendon insertion. On the lateral heel radiograph the syndrome is characterized by a prominent calcaneal bursal projection, retrocalcaneal bursitis, thickening of the Achilles tendon, and a convexity of the superficial soft tissues at the level of the Achilles tendon insertion, a "pump-bump." An objective method for evaluating prominence of the bursal projection is measurement using the parallel pitch lines. This measurement helps to identify patients with Haglund syndrome and patients predisposed to develop this condition, and also to differentiate local causes of posterior heel pain from systemic causes. The parallel pitch line measurement was determined in 10 symptomatic feet and 78 control feet and the results were analyzed statistically.

Four patients, ranging in age from 6 to 32 years, with surgically proved parosteal lesions of the femoral neck are presented. In one case, magnetic resonance (MR) imaging was the initial study ordered prior to plain radiography, and in three cases MR imaging was performed after plain radiography. Findings in the MR images were abnormal in all four cases; however, the nidus was not identified prospectively. Incorrect diagnoses based on findings at MR imaging of secondary marrow edema and/or synovitis included Ewing tumor, osteonecrosis, stress fracture, Lyme arthritis, and juvenile inflammatory arthritis. In all four cases, the correct diagnosis of intracapsular osteoid osteoma was made following (a) review of plain radiographs leading to a high index of suspicion and (b) performance of thin-section computed tomographic (CT) studies (in one case a screening CT study with 1-cm-thick sections failed to depict the lesion). In three cases, isotopic bone scans provided useful guidance for planning the CT examination.

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The authors evaluated three cases of soft tissue chondromas in patients aged 55, 57, and 78 years. Two of the lesions occurred in the foot and one in the hand. All three patients had long histories (over 1 year) of a palpable mass and all three had roentgenograms showing well-demarcated lobulated soft tissue lesions with both central and peripheral calcifications. Recognition of this rare benign chondroid lesion on imaging studies is significant since it may be misinterpreted as an aggressive lesion or a primary synovial abnormality.