Diagnosing heel pain in adults.

Heel pain is a common condition in adults that may cause significant discomfort and disability. A variety of soft tissue, osseous, and systemic disorders can cause heel pain. Narrowing the differential diagnosis begins with a history and physical examination of the lower extremity to pinpoint the anatomic origin of the heel pain.

[Extended field-of-view sonography in Achilles tendon disease: a comparison with MR imaging].

Purpose: To evaluate the role of real-time extended field-of-view sonography (EFOVS) in symptomatic Achilles tendon disease in comparison with MR imaging (MRI).

Materials And Methods: Twenty-three symptomatic tendons were examined by conventional grayscale sonography, EFOVS and MRI, which served as the gold standard.

Results: The median tendon thickness in MRI was 7.

[Impingement lesion of the distal anterior Achilles tendon in sub-Achilles bursitis and Haglund-pseudoexostosis-a therapeutic challenge].

Retrocalcaneal bursitis in athletes is frequently misdiagnosed. Results of conservative treatment are not very promising. This investigation evaluates the results of 39 consecutive cases in 38 patients surgically treated due to chronic retrokalkaneal bursitis in a sport specific population.

Retrospective study of 24 cases of septic calcaneal bursitis in the horse.

Reasons For Performing Study: Wounds to the plantar aspect of the tarsus present a diagnostic and treatment challenge. This study was undertaken to describe specific features of traumatic wounds involving the calcaneal bursa, with a view to determining which clinical examination findings and diagnostic tests results could provide reliable indicators of prognosis.

Objectives: To report clinical presentation, diagnostic findings, treatment and outcome of 24 cases of septic calcaneal bursitis; and to determine the importance of the involvement of specific anatomical structures in relation to the prognosis for survival and return to athletic function.

Sonographic study of calcaneal entheses in erosive osteoarthritis, nodal osteoarthritis, rheumatoid arthritis and psoriatic arthritis.

Objective: To establish by ultrasonography (US) the frequency of calcaneal entheses involvement in erosive osteoarthritis (EOA), nodal osteoarthritis (NOA), RA and PsA, and to compare these results in order to aid clinicians in the differential diagnosis among these diseases. A comparison between US results and radiography was also made.

Methods: The heels of 56 consecutive outpatients with EOA, 209 with NOA, 158 with RA and 125 with PsA were studied by US and radiography.

Intractable malleolar bursitis treated with lateral calcaneal artery adipofascial flap.

Infections of the malleolar bursa, which is an adventitious bursa, rarely progress to intractable infectious bursitis. We present two cases of intractable malleolar bursitis. We performed successful transplantation of the lateral calcaneal artery adipofascial flap that resulted in healing of the bursitis.

Endoscopic decompression of the retrocalcaneal space.

Background: Pain in the retrocalcaneal space can be incapacitating. Patients who do not respond to nonoperative treatment may seek a surgical solution. The first purpose of this paper was to describe and evaluate the efficacy of a minimally invasive procedure to address retrocalcaneal pain caused by retrocalcaneal bursitis, a Haglund spur, and impingement.

[Operative treatment of Haglund's deformity].

The paper presents results of the operative treatment of 22 heel in 18 patients mostly young women from 13 to 31 years old (average 20.6) with Haglund's exostosis. Operative technique consisted in partial resection of the heel with removal of the Achilles bursa.

Endoscopic calcaneoplasty--rationale, surgical technique, and early results: a preliminary report.

We present our technique and preliminary results with endoscopic calcaneoplasty in ten patients resistant for conservative therapy for more than 6 months. All patients showed a Haglund spur on radiography; none had a cavovarus deformity. Follow-up ranged from 2 to 12 months (mean 5.

[Value of ultrasound in diagnosis of bursopathies in the area of the Achilles tendon].

Aim: The goal of this study was to check the usefulness of ultrasonography as a diagnostic tool for a bursitis in the area of the Achilles tendon. Furthermore, we assessed the shape and size of the retrocalcaneal bursa of normal subjects.

Method: The ultrasonograms of 28 patients with a bursitis at the Achilles tendon were analysed.

Endoscopic calcaneoplasty.

Endoscopic calcaneoplasty offers access to the retrocalcaneal space, thereby making it possible to remove inflamed retrocalcaneal bursa as well as the posterosuperior part of the calcaneus in applicable cases of painful hindfoot. In this study, endoscopic calcaneoplasty was performed in 21 procedures in 20 patients. All of the patients had typical complaints of inflammation of the retrocalcaneal bursa that were unresponsive to nonoperative treatment for more than 6 months.

[Bursitis tendinis calcanei in extensive calcaneus erosion].

Introduction: Mechanical and static stress as well as rheumatic diseases may cause retrocalcanear bursitis. Anatomic variants of the calcaneus predispose to this bursitis.

Case: A 51-year-old woman being afraid of operation waited 2 years before undergoing bursectomy al her right heel.

Inflamed retrocalcaneal bursa and Achilles tendonitis in psoriatic arthritis demonstrated by ultrasonography.

Objective: To demonstrate the use of high resolution ultrasound measurements and power Doppler mode in the diagnosis and follow up of a patient with psoriatic arthritic with retrocalcaneal bursitis and Achilles tendonitis.

Methods: An outpatient based ATL HDI 3000 ultrasound equipment was used with a CL10-5 MHZ 26 mm probe and musculoskeletal software. Real time B mode and power Doppler mode were used to detect changes in structure and blood flow.

Osteolytic lesions of the tuber calcanei in two horses.

Two adult horses were evaluated for chronic hind limb lameness. Nonseptic calcanean bursitis with associated focal osteolytic lesions at the point of insertion of the gastrocnemius tendon was diagnosed in each horse by physical and lameness examinations, radiography, ultrasonography, and synovial fluid analysis. Both horses underwent arthroscopic exploration and lavage of the affected bursa, and one horse also underwent surgical debridement of the osseous lesion.

Comparison of results of retrocalcaneal decompression for retrocalcaneal bursitis and insertional achilles tendinosis with calcific spur.

Sixteen feet with retrocalcaneal bursitis (RB) and twenty-two feet with calcific Achilles insertional tendinosis (IAT-CS) underwent retrocalcaneal decompression after failure of nonoperative treatment. Follow-up evaluation at least two years after surgery included AOFAS Ankle-Hindfoot subscale scores, satisfaction, time until maximum symptomatic improvement, and radiographs. Statistically significant differences between the groups include the following: IAT-CS patients were older, required nearly twice the time to reach maximum symptomatic improvement, had lower satisfaction rates, had a lower pain score, and more frequently had shoewear restrictions.

MRI-induced retrocalcaneal bursitis.

This case report describes a patient with acute retrocalcaneal bursitis, which developed after MRI examination of the ankle. The sagittal T2*-weighted gradient echo sequence revealed an extensive susceptibility artifact in the area surrounding the Achilles tendon near its insertion at the os calcis. This artifact was caused by postsurgical metallic particles.

Risk of avulsion of the Achilles tendon after partial excision for treatment of insertional tendonitis and Haglund's deformity: a biomechanical study.

Surgical treatment of posterior heel pain caused by insertional (calcific) Achilles tendonitis or retrocalcaneal bursitis includes resection of diseased tendon or exostectomy. Currently, no guidelines exist to determine how much tendon may be excised without risking rupture of the Achilles tendon. Anatomic dissections revealed the average height of the insertion measured 19.

[Is calcaneal osteotomy justified in Haglund's disease?].

Purpose Of The Study: The authors report their experience of Zadek's wedge osteotomy in the treatment of posterior talalgia in adults and evaluate the various radiographical measurements for calcaneus deformity measurement...

Hypertrophic peroneal tubercle with stenosing tenosynovitis: the results of surgical treatment.

Background: A hypertrophic peroneal tubercle creates a stenotic tunnel which triggers a painful peroneal longus. The painful condition is rare, so delayed diagnosis frequently occurs. The purpose of this study was to retrospectively analyze the diagnosis and the functional results of this condition.

[Rheumatic diseases of the ankle joint and tarsus].

Diseases of the hindfoot are associated with considerable functional impairment and therefore may hamper patients' movements during gait considerably. Because of biomechanical overload, articular structures, tendons and ligaments are prone to early degenerative changes during the course of rheumatic diseases as visible with plain film radiography, sonography (US), or magnetic resonance imaging (MRI). Findings may occur as arthritis of major joints or in the form of fibroostitis and bursitis of the os calcis.

Endoscopy of the calcaneal bursa in horses.

Objective: To describe endoscopic approaches to the calcaneal bursa and clinical findings in 2 horses with calcaneal bursitis.

Study Design: Cadaver evaluations and retrospective case reports.

Animals: 12 cadavers and 2 adult horses.

Retrocalcaneal bursitis in spondyloarthropathy: assessment by ultrasonography and magnetic resonance imaging.

Objective: To establish by magnetic resonance imaging (MRI) and ultrasonography (US) the frequency of retrocalcaneal bursa involvement in Achilles enthesitis of spondyloarthropathy (SpA) and to compare the results of the 2 examinations.

Methods: Nineteen Achilles tendons with severe enthesitis and 9 normal tendons of 14 patients meeting the Amor criteria for SpA were examined by MRI and US.

Results: Both MRI and US showed a significant increase in the mean Achilles tendon thickness in the pathologic legs compared to the normal legs both at the superior calcaneal surface and 3 cm above.