Background:

Enthesopathies are very frequent, the concepts of entesis, and enthesopathy have changed substantially in the last decade.

Clinical case:

A 79-year-old female with pain of 8 months of evolution in both heels, either at the plantar level as in distal Achilles tendon insertion, which has gradually become incapacitating for the ambulation of more than 50 meters. At the exploration: prominence on the posterior face of both heels, Achilles tendon thickening with aching upon stretching, in addition to pain in internal tuberosity of calcaneus at the insertion of plantar fascia. With functional assessment on the AVIS-A scale of 28. Lateral radiographs confirmed bilateral Haglund deformity and ossification of the Achilles tendon insertion, as well as at sites of proximal insertion of the flexor digitorum profundus and the plantar fascia. It were prescribed conservative measures, noting that if there is no improvement in symptoms, the patient is a candidate for surgery.

Conclusions:

Most of the enthesopathies located in heel resolve with conservatively, however, when they are chronic, surgery provides satisfactory results.