The pre-Achilles fat pad: An aid to early diagnosis of local or systemic disease

Goodman, L. R.; Shanser, Jon D.

doi:10.1007/bf00360986

Cited by 18 publications

(7 citation statements)

References 13 publications

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“…However, digitalized images provide more detailed information than conventional plain radiographs [16,19]. The main advantages of DR are its relatively high resolution, adjustable contrast and brightness, and the ability to reprocess images to obtain additional information; they thus provide sharper and more detailed images of soft tissue than conventional film radiographs [18,20]. The simple radiographic findings of the heel, even with digital images, could not be comparable to ultrasonography or magnetic resonance imaging to detect enthesitis.…”

Section: Discussionmentioning

confidence: 99%

Does Painful Heels in Ankylosing Spondylitis Demonstrate Distinctive Features on Plain Radiographs: A Study of 104 Cases

et al. 2017

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Objective. To investigate simple radiographic findings on painful heels in ankylosing spondylitis (AS). Heel radiography in most studies was from AS patients' non-painful heel. Methods. Seventy AS patients (34 bilateral cases) with heel pain at the time digital radiographs were taken were studied. Standing lateral views (104 radiographs) of the heel were reviewed. Associations between radiologic abnormalities and disease duration and among various abnormal findings were analyzed. Results. Ninety-six (93.4%) had radiographic abnormalities (82.7% in soft tissues/61.5% in bone). Abnormalities of bone only were observed in 9.6%, of the soft tissues only in 30.8%, and of both were 51.9%. These included Kager's triangle's blurring (77.9%), posterior soft tissue swellings near the Achilles tendon insertion (65.4%), obliterations of the retrocalcaneal recess (65.4%), erosions of the superior pole of the posterior calcaneus (31.7%), subplantar irregular spurs (20.2%), posterior traction spurs (16.3%), subplantar erosions (14.4%) and cortical thickenings of the inferior calcaneal body (5.8%). There was a significant association between swelling in the posterior soft tissue and obliteration of the retrocalcaneal recess (p＜0.001). Conclusion. Digital radiography in AS is useful for observing not only bony lesions but also soft tissue abnormalities of the heel, particularly of the posterior heel. For assessing the symptomatic enthesitis of the Achilles, this simple and quick diagnostic tool is valuable when examining for soft tissues' alterations of the posterior heel. (J Rheum Dis 2017;24:93-98)

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Section: Discussionmentioning

confidence: 99%

Does Painful Heels in Ankylosing Spondylitis Demonstrate Distinctive Features on Plain Radiographs: A Study of 104 Cases

et al. 2017

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“…In front of it lies a fat pad, the triangle of Kager, which appears as a triangular lucency behind the deep muscle adjacent to the tibia [9,15]. When tendon xanthomata develop, the Achilles tendon enlarges two to three times its normal size.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography of tendinous xanthomata in cerebrotendinous xanthomatosis

Hertzanu

Berginer

1991

Skeletal Radiol.

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Tendinous xanthomata with maximum expression on Achilles tendons are a characteristic feature of cerebrotendinous xanthomatosis, a rare autosomal recessive lipid storage disease. Twenty patients are under review; three of them, at different stages of the disease, underwent computed tomographic (CT) examination. CT demonstrates with a high degree of accuracy the increased size of the tendon and its heterogeneous structure resulting from cholesterol and cholestanol crystal deposits.

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“…Normally this fat pad, as seen on a weight-bearing lateral radiograph of the ankle, is a triangular radiolucency with sharp, gently curving borders (Goodman and Shanser 1997) (Figure 1). …”

Section: Introductionmentioning

confidence: 99%

“…Kager's fat pad, also known as the pre-Achilles fat pad, occupies Kager's triangle ( Theobald et al 2006 ). Normally this fat pad, as seen on a weight-bearing lateral radiograph of the ankle, is a triangular radiolucency with sharp, gently curving borders ( Goodman and Shanser 1997 ) ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

Sterkenburg¹,

Muller²,

Maas

et al. 2010

Acta Orthopaedica

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Background and purposeA retrocalcaneal bursitis is caused by repetitive impingement of the bursa between the Achilles tendon and the posterosuperior calcaneus. The bursa is situated in the posteroinferior corner of Kager's triangle (retrocalcaneal recess), which is a radiolucency with sharp borders on the lateral radiograph of the ankle. If there is inflammation, the fluid-filled bursa is less radiolucent, making it difficult to delineate the retrocalcaneal recess. We assessed whether the radiographic appearance of the retrocalcaneal recess on plain digital (filmless) radiographs could be used in the diagnosis of a retrocalcaneal bursitis.MethodsWhether or not there was obliteration of the retrocalcaneal recess (yes/no) on 74 digital weight-bearing lateral radiographs of the ankle was independently assessed by 2 observers. The radiographs were from 24 patients (25 heels) with retrocalcaneal bursitis (confirmed on endoscopic calcaneoplasty); the control group consisted of 50 patients (59 heels).ResultsThe sensitivity of the test was 83% for observer 1 and 79% for observer 2. Specificity was 100% and 98%, respectively. The kappa value of the interobserver reliability test was 0.86. For observer 1, intraobserver reliability was 0.96 and for observer 2 it was 0.92.InterpretationOn digital weight-bearing lateral radiographs of a retrocalcaneal bursitis, the retrocalcaneal recess has a typical appearance.

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The pre-Achilles fat pad: An aid to early diagnosis of local or systemic disease

Cited by 18 publications

References 13 publications

Does Painful Heels in Ankylosing Spondylitis Demonstrate Distinctive Features on Plain Radiographs: A Study of 104 Cases

Does Painful Heels in Ankylosing Spondylitis Demonstrate Distinctive Features on Plain Radiographs: A Study of 104 Cases

Computed tomography of tendinous xanthomata in cerebrotendinous xanthomatosis

Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

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