Table 1 Overview of calcaneal spur characteristics and regular calcaneal features that can be mistaken for true spurs.

From: Why heel spurs are traction spurs after all

 

Spur-free AT enthesis

Posterior spur

Spur free PF enthesis

Plantar spur

Spur tip

–

Points towards preferred collagen orientation of AT

–

Points towards preferred collagen orientation of PF

Presence of trabeculae in spurs

–

All spurs

–

All spurs

Trabecular pattern

–

No preferred orientation

–

No preferred orientation

Enthesial fibrocartilage

–

All spurs

–

All spurs

Spur location

–

Intratendinous (in posterior part of AT insertion)

–

Intra- or subfascial

Surface features that can be mistaken for spurs

Calcaneal spine, cortical irregularities (up to 2 mm)*

–

Medial/lateral calcaneal process, cortical irregularities (up to 2 mm)*

 
  1. AT Achilles tendon, PF Plantar fascia.
  2. *Limit adapted from Kirckpatrick et al.8 for plantar spurs.