The retrocalcaneal bursa is the primary clinical bursa of the Achilles insertion, distinguishable from the superficial subcutaneous Achilles bursa. Retrocalcaneal bursitis from Haglund's deformity produces posterior heel pain at the tendon-bone interface, worsened by shoe counter pressure and dorsiflexion. MRI shows bursal distension between the tendon and the Haglund's prominence as bright T2 signal.
Allows the Achilles tendon to glide over the posterosuperior calcaneal surface during plantarflexion and dorsiflexion
Haglund's syndrome (combined retrocalcaneal bursitis and insertional Achilles tendinopathy from the posterosuperior calcaneal prominence) produces posterior heel pain. Conservative treatment: heel lifts, shoe modification, physiotherapy. Surgical treatment: endoscopic or open retrocalcaneal bursectomy with Haglund's resection (calcaneal exostectomy) achieves 85% good-excellent outcomes.
Retrocalcaneal bursitis with Haglund's prominence producing posterior heel pain managed with heel lifts and endoscopic bursectomy plus exostectomy.
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