title: [Study of the morphology of heel spur and clinical significance: base on three-dimensional computed tomography].
abstract: OBJECTIVE
  To evaluate the characteristic morphology of heel spur, and to investigate the relationship of heel spur and plantar heel pain.
  
  
  METHODS
  From June 2005 to April 2009, 210 cases (254 feet) with heel spur (according to Denis Pain Scale) were divided into cases group 1 (P2, n = 46), 2 (P3, n = 44), 3 (P4, n = 42), 4 (P5, n = 36) and controls group (P1, n = 42). Three-dimensional reconstruction of heel spur was performed in all groups using volume rendering based on multi-slice CT data by Super Image orthopedics edition 1.0. The characteristic morphology of heel spur was observed and the data were measured and analyzed, involving the width of basilar part, the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur.
  
  
  RESULTS
  Parts of cases groups displayed coarse arcuate edge and undersurface with one or more little heel spurs adhere to heel spur, of which the numbers were greater than controls group, especially in cases group 4. No significant difference of the width of basilar part of heel spur was found among 5 groups (F = 2.32, P > 0.05). However, obvious difference was found in the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur (F = 8.23, 6.82, 5.87, P < 0.05). Compared with the controls group, the angle between heel spur and planta pedis of cases groups had higher degrees, but the difference of the other data presented irregular.
  
  
  CONCLUSIONS
  The characteristic morphology of heel spur varies in patients associated with plantar heel pain. No correlation is found between the severity and the morphological data, including the width of basilar part, the length, the angle between heel spur and planta pedis, and the angle between the longitudinal axis of calcaneus and heel spur.
authors.affiliation: Department of Orthopaedics, Tongji Hospital, Tongji University, Shanghai 200065, China. cyxtongji@yahoo.com.cn
authors.forename: Yan-xi
authors.initials: YX
authors.lastname: Chen
authors.forename: Jiong
authors.initials: J
authors.lastname: Mei
authors.forename: Guang-rong
authors.initials: GR
authors.lastname: Yu
authors.forename: Xin-cheng
authors.initials: XC
authors.lastname: Liu
authors.forename: Zhe-ren
authors.initials: ZR
authors.lastname: Wang
mesh_terms: D000368:Aged; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D036982:Heel Spur / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed