Calcaneal bursitis: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*'''Retrocalcaneal bursitis''' | *'''Retrocalcaneal bursitis''' | ||
*'''Retroachilles bursitis''' | *'''Retroachilles bursitis''' | ||
*Septic bursitis | *[[Septic bursitis]] | ||
*[[Septic arthritis]] | *[[Septic arthritis]] | ||
*[[Calcaneus fracture]] | *[[Calcaneus fracture]] | ||
*Friction blister | *Friction blister | ||
{{Foot diagnoses}} | {{Foot diagnoses}} | ||
{{Calf pain DDX}} | |||
==Management== | ==Management== | ||
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*Rest, Ice, Compression, Elevation | *Rest, Ice, Compression, Elevation | ||
*Achilles padding in shoe wear | *Achilles padding in shoe wear | ||
*Physical therapy | *Physical therapy → achilles stretching | ||
*[[NSAID]]s | *[[NSAID]]s | ||
*Bursa aspiration | *Bursa aspiration | ||
*Avoid steroid injections | *Avoid steroid injections secondary to risk of achilles rupture | ||
==Disposition== | ==Disposition== | ||
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==External Links== | ==External Links== | ||
*[http://www.orthobullets.com/foot-and-ankle/7022/achilles-tendonitis | *[http://www.orthobullets.com/foot-and-ankle/7022/achilles-tendonitis Orthobullets - Achilles Tendonitis] | ||
==References== | ==References== | ||
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[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
[[Category:Sports Medicine]] | |||
Latest revision as of 16:16, 18 October 2019
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
- Retrocalcaneal bursitis
- Retroachilles bursitis
- Septic bursitis
- Septic arthritis
- Calcaneus fracture
- Friction blister
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
Calf pain
- Achilles tendon rupture
- Calcaneal bursitis
- Cellulitis
- Compartment syndrome
- Deep venous thrombosis (DVT)
- Distal leg fractures
- Gastrocnemius strain
- Ruptured popliteal cyst (Bakers cyst)
- Superficial thrombophlebitis
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