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Calcaneal tuberosity

The calcaneal tuberosity is the large posterior bony prominence of the calcaneus (heel bone) forming the weight-bearing portion of the heel. It serves as a major attachment site for powerful tendons and ligaments and plays a critical role in load transmission during standing and gait.

It is a key anatomical landmark in foot and ankle anatomy, trauma evaluation, sports medicine, and musculoskeletal imaging.

Synonyms

  • Tuber calcanei

  • Heel tuberosity

Location

  • Situated at the posterior aspect of the calcaneus

  • Forms the most inferior and posterior part of the heel

  • Inferior to the talus

  • Posterior to the subtalar joint

  • In direct contact with the ground during weight-bearing

Anatomical components

  • Posterior calcaneal prominence

  • Medial and lateral processes:

    • Serve as attachment points for plantar fascia

  • Posterior surface:

    • Provides attachment for the Achilles (calcaneal) tendon

  • Inferior surface:

    • Forms the weight-bearing heel pad interface

Relations

Anteriorly:

  • Body of the calcaneus

  • Subtalar joint

Posteriorly:

  • Achilles tendon

Superiorly:

  • Retrocalcaneal bursa

  • Posterior talar region

Inferiorly:

  • Plantar fat pad

  • Skin of the heel

Medially:

  • Abductor hallucis muscle origin

Laterally:

  • Abductor digiti minimi muscle origin

X-ray appearance

Plain radiographs (lateral and axial heel views):

  • Calcaneal tuberosity: Seen as the posterior projection of the calcaneus

  • Cortical outline: Thick and dense

  • Trabecular pattern: Prominent cancellous bone

  • Best visualized on: Lateral and axial (Harris) views

CT appearance

Non-contrast CT:

  • Tuberosity: Well-defined posterior bony prominence

  • Cortical margins: Thick and sharply outlined

  • Trabecular structure: Clearly visualized

  • Spatial evaluation: Excellent for contour and structural assessment

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Marrow of tuberosity: High signal intensity

  • Achilles tendon attachment: Seen as a low-signal band inserting posteriorly

T2-weighted images:

  • Cortex: Low signal

  • Marrow: Intermediate signal

  • Adjacent bursae and soft tissues: High signal

STIR:

  • Marrow fat suppression: Uniform signal suppression

  • Tuberosity margins: Clearly delineated

  • Soft tissues and bursae: Bright signal

Proton density fat-saturated (PD FS):

  • Bone marrow: Fat signal suppressed

  • Achilles tendon: Low-signal structure against bright fluid

  • Excellent contrast: Between bone, tendon, and surrounding soft tissues

CT VRT 3D image

Calcaneal tuberosity 3d

CT VRT 3D image

Calcaneal tuberosity 3d1

MRI image

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

MRI image

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