AJR Am J Roentgenol. 2015 Nov;205(5):1061-7. doi: 10.2214/AJR.14.14190.
Yu SM1, Yu JS1.
OBJECTIVE: The calcaneus is the primary weight bearing bone in the heel, and its many surface contours render it a relatively difficult bone to visualize in its entirety. The stabilizing ligaments that hold the calcaneus in place occupy very specific locations, and the Achilles tendon enthesis is in a relatively constant location; therefore, avulsion fractures occur in reproducible locations.
CONCLUSION: The mechanisms of injuries include overuse and neuropathic conditions, although most cases are related to trauma.