Topics

Topic

design image
Calcaneal tubercle

The calcaneal tubercle (also called the calcaneal tuberosity) is the large posterior and inferior bony prominence of the calcaneus forming the heel. It is a critical weight-bearing structure and serves as a major attachment site for ligaments, fascia, and muscles involved in foot support and propulsion.

It is a key landmark in foot anatomy, trauma assessment, sports medicine, and imaging of hindfoot structures.

Synonyms

  • Calcaneal tuberosity

  • Heel tubercle

Location

  • Situated at the posterior-inferior aspect of the calcaneus

  • Forms the bony prominence of the heel

  • Inferior to the posterior facet of the subtalar joint

  • Posterior to the plantar surface of the foot

  • Superficial and subcutaneous in the heel region

Anatomical components

  • Medial process:

    • Larger and more prominent

    • Major weight-bearing component

  • Lateral process:

    • Smaller and less prominent

  • Cortical shell with cancellous core

  • Major attachment sites:

    • Plantar fascia (plantar aponeurosis)

    • Abductor hallucis

    • Flexor digitorum brevis

    • Abductor digiti minimi

Relations

Posteriorly:

  • Skin and heel fat pad

Anteriorly:

  • Body of the calcaneus

Superiorly:

  • Posterior calcaneus and Achilles tendon insertion (nearby)

Inferiorly:

  • Plantar soft tissues and plantar fascia

Medially:

  • Medial plantar neurovascular structures

Laterally:

  • Lateral plantar neurovascular structures

X-ray appearance

Plain radiographs (lateral and axial heel views):

  • Calcaneal tubercle: Prominent posterior-inferior bony projection

  • Cortical outline: Thick and well-defined

  • Medial and lateral processes: Best appreciated on axial views

  • Heel contour: Forms the posterior outline of the calcaneus

CT appearance

Non-contrast CT:

  • Tubercle: Well-defined posterior-inferior bony prominence

  • Cortical margins: Thick and sharply outlined

  • Trabecular pattern: Normal cancellous bone

  • Medial and lateral processes: Clearly distinguished

  • Useful for: Detailed assessment of morphology and subtle cortical irregularities

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Marrow within tubercle: High signal intensity

  • Plantar fascia attachment: Well visualized as low-signal band

T2-weighted images:

  • Cortex: Low signal

  • Adjacent soft tissues and fat pad: High signal

  • Plantar fascia: Low signal against surrounding soft tissues

STIR:

  • Fat suppression: Uniform suppression of marrow fat

  • Tubercle margins: Clearly outlined

  • Plantar soft tissues: High signal contrast

Proton density fat-saturated (PD FS):

  • Bone marrow: Suppressed fat signal

  • Soft tissues: High contrast visualization

  • Plantar fascia attachment: Well delineated

CT VRT 3D image

Calcaneal tubercle 3d

MRI image

Calcaneal tubercle mri anatomy labelled image-img-00000-00000

MRI image

Calcaneal tubercle mri anatomy labelled image-img-00000-00000_00001