Retrocalcaneal bursa injection introduction Retrocalcaneal bursitis (RCBS) is a frequent cause of posterior heel pain and is often accompanied by insertional Achilles tendinosis (IAT).
Retrocalcaneal bursa injection introduction Retrocalcaneal bursitis (RCBS) is a frequent cause of posterior heel pain and is often accompanied by insertional Achilles tendinosis (IAT). RCBS occurs with athletic overactivity seen in runners or ballet dancers, in the setting of inflammatory arthropathy, and in Haglund disease which is associated with use of certain footwear (women’s heels and hockey skates) and prominence of the posterosuperior calcaneus. Heel pain caused by IAT and RCBS may also be seen in sedentary patients, and has been associated with increasing BMI and physical inactivity.
The retrocalcaneal bursa is a fluid-filled space located between the anteroinferior wall of the Achilles tendon and the posterosuperior surface of the calcaneus. The anterior margin of the bursa is composed of fibrocartilage, the posterior margin is the paratenon of the Achilles tendon and the superior margin is made up of adipose tissue. The bursa lies in the region of the Achilles tendon insertion into the calcaneus, and its function is to reduce friction associated with the tendon's movement in surrounding tissues.
Inflammation of the retrocalcaneal bursa is a common clinical problem and results in localized pain, tenderness, and swelling. Disorders of the bursa are a heterogeneous group of pathologies related to the region of the AT's attachment to the calcaneus, and are classified as either retrocalcaneal bursitis or superficial calcaneal bursitis. The clinical diagnosis of RCBS is supported by pain elicited during the two-finger squeeze test, performed by applying medial and lateral pressure anterior to the Achilles tendon.
Typically the patient will complain of pain above the calcaneus. In athletes, this pain will typically be worse at the start of exercise and improve some during exercise. Treatment of bursitis may include the use of nonsteroidal anti-inflammatory drugs, cryotherapy and shoe modification.
In more severe cases, localised corticosteroid injections may be used to reduce inflammation. Location of the retrocalcaneal bursa on ultrasound. However, corticosteroid treatment is controversial.
If you are experiencing symptoms that may be related to retrocalcaneal bursa injection, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
Connect with a doctor, physical therapist, or imaging center near you.
Find a Provider Near You →