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Medial process of calcaneal tuberosity

The medial process of the calcaneal tuberosity is the medial bony projection arising from the posterior plantar aspect of the calcaneus. It forms a key part of the heel’s weight-bearing surface and serves as an important attachment site for plantar soft tissues.

It is a critical anatomical landmark in foot biomechanics, plantar heel pain assessment, trauma evaluation, and imaging of the hindfoot.

Synonyms

  • Medial tubercle of the calcaneus

  • Medial calcaneal process

Location

  • Situated on the posteroinferior aspect of the calcaneus

  • Forms the medial part of the calcaneal tuberosity

  • Inferior to the posterior calcaneal body

  • Medial to the lateral process of the calcaneal tuberosity

  • Deep to the plantar soft tissues of the heel

Anatomical components

  • Osseous prominence of the calcaneus

  • Cortical shell with underlying cancellous bone

  • Major attachment site for:

    • Plantar fascia (medial band)

    • Abductor hallucis muscle

    • Flexor digitorum brevis muscle

  • Part of the primary weight-bearing surface of the heel

Relations

Anteriorly:

  • Body of the calcaneus

Posteriorly:

  • Posterior calcaneal surface

Medially:

  • Abductor hallucis muscle

Laterally:

  • Lateral process of the calcaneal tuberosity

Inferiorly:

  • Plantar fascia and plantar fat pad

Superiorly:

  • Calcaneal body and subtalar joint region

X-ray appearance

Plain radiographs (lateral and axial calcaneal views):

  • Medial process: Seen as a rounded or pointed plantar bony projection

  • Cortical margins: Smooth and well-defined

  • Position: Forms the plantar contour of the heel

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

CT appearance

Non-contrast CT:

  • Medial process: Clearly visualized bony projection from the plantar calcaneus

  • Cortical margins: Sharp and continuous

  • Trabecular pattern: Normal cancellous bone

  • Spatial assessment: Excellent depiction of size, shape, and relation to lateral process

  • Relationship to plantar fascia: Inferred from anatomical location

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Calcaneal marrow: High signal intensity

  • Medial process contour: Well outlined against surrounding soft tissues

T2-weighted images:

  • Cortex: Low signal

  • Adjacent soft tissues: Intermediate-to-high signal

  • Plantar fascia insertion: Seen as a low-signal band attaching to the medial process

STIR:

  • Fat suppression: Uniform suppression of marrow fat

  • Medial process margins: Clearly delineated

  • Plantar fascia and surrounding soft tissues: High signal contrast

Proton density fat-saturated (PD FS):

  • Bone marrow: Suppressed fat signal

  • Plantar fascia: Low-signal band clearly seen at its calcaneal attachment

  • Soft-tissue contrast: Excellent for evaluating the insertional region

CT VRT 3D image

Medial process of calcaneal tuberosity 3d

MRI image

Medial process of calcaneal tuberosity mri anatomy labelled image-img-00000-00000

MRI image

Medial process of calcaneal tuberosity mri anatomy labelled image-img-00000-00000_00001