II. Epidemiology

  1. Middle aged and older adults

III. Predisposing factors

  1. Overuse injury in athletes
  2. Low cut shoes

IV. Anatomy

  1. General
    1. Two bursae located near achilles tendon insertion
  2. Superficial Calcaneal Bursa (Pump-Bump)
    1. Located over achilles tendon
    2. Irritated by constant rubbing by shoe
    3. Associated with thin heel pad
  3. Retrocalcaneal bursa
    1. Located under achilles tendon
    2. Irritated by Calcaneus
      1. Prominent posterosuperior angle (Haglund's Disease)

V. Symptoms

  1. Heel Pain with swelling and erythema
  2. Pain exacerbating factors
    1. Worse at the beginning of activity (e.g. walking)
    2. Wearing shoes may worsen pain
  3. Painful limp may develop

VI. Signs

  1. Inflammation at achilles tendon insertion on Calcaneus
  2. Images
    1. ankleAchillesBursa.jpg

VII. Differential Diagnosis

  1. See Heel Pain

VIII. Imaging

  1. Indicated only in refractory cases
  2. Haglund's Deformity
    1. Bone spur on superior Calcaneus
    2. Calcified distal achilles tendon

IX. Management

  1. General Measures
    1. Heel pads
    2. NSAIDs
    3. Alternate Ice Therapy with heat therapy
    4. Consider wearing sandals (open back)
    5. Elevation of shoe heel with soft cushion
  2. Corticosteroid Injection not recommended
    1. Exercise caution in local steroid injections here
    2. Risk of Achilles Tendon Rupture or weakening
  3. Surgery for refractory cases
    1. Bursa and bony prominence resection

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Achilles bursitis (C0149846)

Concepts Disease or Syndrome (T047)
ICD9 726.71
ICD10 M76.6
SnomedCT 221695002, 202879008, 87494005, 203394008, 74859007, 320481000009105
English Achilles bursitis, Haglund's deformity, Achilles tendinitis, tendonitis achilles, haglund's deformity, achilles bursitis, albert's syndrome, alberts disease, haglund's disease, achilles tendonitis, Haglund's disease, Calcaneal osteochondritis, Inflammation of calcaneal bursa (disorder), Inflammation of calcaneal bursa, Calcaneal bursitis, Achillobursitis, Albert's syndrome, Swediaur's disease, Achilles bursitis (disorder), Capped hock, bursitis; calcaneal, calcaneal; bursitis, achillobursitis, Swediauer's disease, Achilles bursitis (disorder) [Ambiguous], Achilles bursitis or tendinitis, Haglund deformity
Dutch Haglund-misvorming, bursitis of tendinitis van achillespees, bursitis van achillespees, bursitis; calcaneus, calcaneus; bursitis
French Bursite ou tendinite du tendon d'Achille, Difformité de Haglund, Bursite du tendon d'Achille
German Achillesbursitis oder Tendinitis, Achillobursitis, Haglund-Ferse
Italian Deformità di Haglund, Borsite achillea, Tendinite o borsite del tendine d'Achille
Portuguese Deformidade de Haglund, Bursite aquiliana, Bursite ou tendinite aquiliana
Spanish Bursitis o tendinitis aquílea, Deformidad de Haglund, Bursitis del tendón de Aquiles, aquilobursitis, osteocondritis calcánea, bursitis aquileana (concepto no activo), bursitis aquileana (trastorno), bursitis aquileana, enfermedad de Haglund, enfermedad de Swediaur, síndrome de Albert
Japanese ハグルンド変形, アキレス腱滑液包炎, ハグルンドヘンケイ, アキレスケンカツエキホウエン
Czech Burzitida nebo tendinitida Achillovy šlachy, Burzitida Achillovy šlachy, Haglundova deformace
Hungarian Achillobursitis, Haglund-féle deformitás, Achilles bursitis vagy tendinitis

Ontology: Posterior calcaneal exostosis (C0410104)

Concepts Anatomical Abnormality (T190)
SnomedCT 202883008
English Posterior calcaneal exostosis (pump bump), Pump bump, Posterior calcaneal exostosis (pump bump) (disorder), Haglund deformity, Haglund's deformity, Posterior calcaneal exostosis (disorder), Posterior calcaneal exostosis
Spanish deformidad de Haglund, exostosis calcánea posterior (trastorno), exostosis calcánea posterior

Ontology: Postcalcaneal bursitis (C0410130)

Concepts Disease or Syndrome (T047)
SnomedCT 202935009, 240033006
English retrocalcaneal bursitis (diagnosis), retrocalcaneal bursitis, bursitis retrocalcaneal, Postcalcaneal bursitis, RCB - Retrocalcaneal bursitis, Retrocalcaneal bursitis, Postcalcaneal bursitis (disorder)
Spanish bursitis retrocalcánea (trastorno), bursitis retrocalcánea