Calcaneal intraosseous lipoma: A rare cause of heel pain

Abstract Background Intraosseous lipoma is a rare benign tumor representing 0.1% of all skeletal tumors. We report a new case of plantar heel pain revealing intraosseous lipoma of the calcaneus. Aim of the work To increase clinical awareness of calcaneal lipoma and to highlight the contribution of imaging in the diagnosis of patients with persistent heel pain. Case report A 67-years-old Tunisian man presented to the Rheumatology department, Kassab Orthopaedic Institute, Faculty of Medicine, University of Tunis el Manar with a four months history of persistent left heel pain. The pain became worse during walking and disappeared at rest. He had no history of trauma. The physical examination was normal, except for tenderness to palpation of the left heel. Radiography of the left heel showed a well-defined lesion in the neck of calcaneus. Magnetic resonance imaging (MRI) was performed and showed a large lesion in the left calcaneus, well demarcated (width: 30 mm, length: 33 mm and height: 18 mm), with high signal intensity on T1 and T2 weighted sequences and low signal in T2 sequences with fat saturation without enhancement after gadolinium injection. The diagnosis of calcaneal lipoma was established and the patient was put on symptomatic treatment and referred to surgery. Conclusion Calcaneal lipoma should be mentioned as a forerunner among the differential diagnoses of persistent heel pain and promptly dealt with for a promising outcome.