Calcaneal bursitis: Difference between revisions
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Revision as of 02:57, 9 February 2017
Background
Can be subdivided into two separate entities: Retrocalcaneal and Retroachilles bursitis
- Retrocalcaneal bursitis - Inflammation of the bursa located posterior to the calacaneal bone, anterior to the achilles tendon
- Retroachilles bursitis - Inflammation of the bursa located between the achilles tendon and posterior skin, adjacent to the insertion of the achilles tendon on the calcaneous
Clinical features
- Pain localized anterior and 2-3cm proximal to insertion of achilles tendon
- Pain with dorsiflexion
- Tenderness and fullness medial and lateral to tendon
Differential Diagnosis
- DVT
- Gastrocnemius strain
- Retrocalcaneal bursitis
- Retroachilles bursitis
- Septic bursitis
- Septic arthritis
- Calcaneus fracture
- Compartment syndrome
- Friction blister
- Achilles tendon rupture
- Cellulitis
- Superficial thrombophlebitis
Foot diagnoses
Acute
- Foot and toe fractures
- Subtalar dislocation
- Metatarsophalangeal joint sprain (turf toe)
- Acute arterial ischemia
- Calcaneal bursitis
Subacute/Chronic
- Diabetic foot infection
- Peripheral artery disease
- Plantar fasciitis
- Trench foot
- Ingrown toenail
- Paronychia
- Tinea pedis
- Morton's neuroma
- Diabetic neuropathy
Management
Conservative management is first-line
- Rest, Ice, Compression, Elevation
- Achilles padding in shoe wear
- Physical therapy → achilles stretching
- NSAIDs
- Bursa aspiration
- Avoid steroid injections secondary to risk of achilles rupture
Disposition
- Typically discharge home