Painful subcutaneous swelling over Achilles tendon, usually at shoe counter
Overlying skin may be hyperkeratotic
More common in women
Due to local irritation from upper edge of a rigid shoe
diagnosis is clinical
MR:
Bursal fluid posterior to distal Achilles with high signal on T2 and STIR images
Treatment:
Rest, heat application, NSAID, padding, change of shoes
Local steroid injection should be avoided
References:
Narváez JA et al. Painful heel: MR imaging findings. Radiographics. 2000;20:333-352
