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<v ->When we look at adventitious bursitis,

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we look at sites where friction may develop,

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and this is one

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that has been well described in the literature.

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It is a pseudotumor that occurs along the medial malleolus,

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related to the wearing of certain types of shoes.

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Typically, shoes with a high rim

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or shoes with a certain type of buckle,

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will irritate this area.

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You can see in this example,

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nicely the well defined

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and the bottom lobulated nature of the fluid

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within this adventitious bursitis.

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Now, other examples of adventitious bursitis,

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include the characteristic bunion,

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that we see at the first metatarsophalangeal joint,

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plantar fat pads,

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which I will show you

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and areas around sites of amputation.

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Here's an example of plantar fat pad bursitis.

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And this is a very common finding

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when we do MR Imaging of the foot.

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Typically, these can be a variable size,

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and located beneath

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the first and fifth metatarsophalangeal joint,

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as they are in this case.

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And in that particular location,

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this pattern of adventitious bursitis can be asymptomatic.

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(clears throat)

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However, if you see a similar pattern

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beneath the other metatarsal heads

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and the second toe is the next site

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in terms of frequency,

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pain on the plantar aspect

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in the fourth foot may be evident.

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Here's an example.

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A nice example of both a adventitious bursitis

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shown by the black arrows here,

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and a primary bursitis,

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involving the intermetatarsal bursitis

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between the third and fourth metatarsal heads

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shown by the orange arrows.

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So both may occur together.

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With regard to intermetatarsal bursitis,

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we won't be discussing it in any detail in this conference,

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but you can see how this particular location

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causes problems when you're trying to figure out

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whether or not you're dealing with an interdigital neuroma,

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such as a Morton's neuroma.