Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

Sterkenburg, Maayke N. van; Muller, Bart; Maas, Mario; Sierevelt, Inger N.; Dijk, C. Niek van

doi:10.3109/17453674.2010.487245

Cited by 30 publications

(18 citation statements)

References 9 publications

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“…The shape and lucency of the Kager triangle on radiographic imaging can also be used to assess for retrocalcaneal bursitis. 112 Ultrasound imaging and magnetic resonance imaging (MRI) can be used to examine for soft-tissue (tendon degeneration, neovascularization, bursitis, paratendinitis) as well as bony (enthesophytes, intratendinous calcification) changes. 13 Signs of tendinopathy on imaging do not necessarily indicate the presence of IAT and vice versa, as demonstrated in several level IV * and level II studies.…”

Section: Imagingmentioning

confidence: 99%

Current Concepts Review Update: Insertional Achilles Tendinopathy

et al. 2017

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Section: Imagingmentioning

confidence: 99%

Current Concepts Review Update: Insertional Achilles Tendinopathy

et al. 2017

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“…In those studies, it was noted that 17% to 58% of patients with AS had radiographic changes in their heels [1,9] and some radiographic alterations were seen in the absence of local symptoms [8,11]. However, there is no information about the incidence and pattern of abnormal findings in symptomatic heels in AS patients.…”

Section: Discussionmentioning

confidence: 99%

“…The concomitant presence of these soft tissue abnormalities strongly suggests that they are the result of current enthesitis of the posterior heel. They have been designated retrocalcaneal bursitis due to the inflammatory changes at the insertion of the Achilles tendon [11,16], which is the prime example of an 'enthesis organ' [17]. Since such soft tissue lesions were not correlated with disease duration, the radiographic changes of soft tissue shadowing may be more relevant to the concurrent state of the heel than the bony changes, and may represent acute lesions, especially in those cases where only soft tissues are affected (30.8%).…”

Section: Discussionmentioning

confidence: 99%

“…Bony abnormalities such as spurs of the plantar and posterior calcaneus (traction or irregular), proliferation, and erosion were assessed as previously described [8,9]. Changes in the shadows of soft tissues comprising the retrocalcaneal recess, and in the vicinity of the insertion of the Achilles tendon and Kager's triangle, were also observed [11]. An experienced orthopedic foot and ankle surgeon (IHS) and a musculoskeletal radiologist (SL) independently evaluated all abnormal findings of bone and soft tissues in plain radiographs twice weekly.…”

Section: Methodsmentioning

confidence: 99%

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Does Painful Heels in Ankylosing Spondylitis Demonstrate Distinctive Features on Plain Radiographs: A Study of 104 Cases

et al. 2017

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Objective. To investigate simple radiographic findings on painful heels in ankylosing spondylitis (AS). Heel radiography in most studies was from AS patients' non-painful heel. Methods. Seventy AS patients (34 bilateral cases) with heel pain at the time digital radiographs were taken were studied. Standing lateral views (104 radiographs) of the heel were reviewed. Associations between radiologic abnormalities and disease duration and among various abnormal findings were analyzed. Results. Ninety-six (93.4%) had radiographic abnormalities (82.7% in soft tissues/61.5% in bone). Abnormalities of bone only were observed in 9.6%, of the soft tissues only in 30.8%, and of both were 51.9%. These included Kager's triangle's blurring (77.9%), posterior soft tissue swellings near the Achilles tendon insertion (65.4%), obliterations of the retrocalcaneal recess (65.4%), erosions of the superior pole of the posterior calcaneus (31.7%), subplantar irregular spurs (20.2%), posterior traction spurs (16.3%), subplantar erosions (14.4%) and cortical thickenings of the inferior calcaneal body (5.8%). There was a significant association between swelling in the posterior soft tissue and obliteration of the retrocalcaneal recess (p＜0.001). Conclusion. Digital radiography in AS is useful for observing not only bony lesions but also soft tissue abnormalities of the heel, particularly of the posterior heel. For assessing the symptomatic enthesitis of the Achilles, this simple and quick diagnostic tool is valuable when examining for soft tissues' alterations of the posterior heel. (J Rheum Dis 2017;24:93-98)

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“…A standing, lateral view of plain X-ray was taken preoperatively, to assess the posterosuperior bony spur,13 (which was present in all patients) and to calculate the extent of bony resection required. Out of 23 patients, seven had Achilles tendon calcification ranging from minima to moderate grade.…”

Section: Methodsmentioning

confidence: 99%

Outcome of endoscopic decompression of retrocalcaneal bursitis

Kondreddi

Gopal

Yalamanchili

2012

IJOO

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Background:Posterior heel pain due to retrocalcaneal bursitis, is a disabling condition that responds well to the conventional methods of treatment. Patients who do not respond to conservative treatment may require surgical intervention. This study evaluates the outcome of endoscopic decompression of retrocalcaneal bursitis, with resection of posterosuperior eminence of the calcaneum.Materials and Methods:This present study included 25 heels from 23 consecutive patients with posterior heel pain, who did not respond to conservative treatment and underwent endoscopic decompression of the retrocalcaneal bursae and excision of bony spurs. The functional outcome was evaluated by comparing the pre and postoperative American Orthopedic Foot and Ankle Society (AOFAS) scores. The Maryland ankle and foot score was used postoperatively to assess the patient's satisfaction at the one-year followup.Results:The University of Maryland scores of 25 heels were categorized as the nonparametric categories, and it was observed that 16 patients had an excellent outcome, six good, three fair and there were no poor results. The AOFAS scores averaged 57.92 ± 6.224 points preoperatively and 89.08 ± 5.267 points postoperatively (P < 0.001), at an average followup of 16.4 months. The 12 heels having noninsertional tendinosis on ultrasound had low AOFAS scores compared to 13 heels having retrocalcaneal bursitis alone. At one year followup, correlation for preoperative ultrasound assessment of tendoachilles degeneration versus postoperative Maryland score (Spearman correlation) had shown a strong negative correlation.Conclusion:Endoscopic calcaneal resection is highly effective in patients with mild or no degeneration and yields cosmetically better results with fewer complications. Patients with degenerative changes in Achilles tendon had poorer outcomes in terms of subjective satisfaction.

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Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

Cited by 30 publications

References 9 publications

Current Concepts Review Update: Insertional Achilles Tendinopathy

Current Concepts Review Update: Insertional Achilles Tendinopathy

Does Painful Heels in Ankylosing Spondylitis Demonstrate Distinctive Features on Plain Radiographs: A Study of 104 Cases

Outcome of endoscopic decompression of retrocalcaneal bursitis

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