0:00

<v ->This is, again, my picture of a retrocalcaneal bursa,

0:04

sitting between the posterior superior surface

0:07

of the calcaneous and the Achilles tendon.

0:11

Now in the normal situation on the radiograph,

0:14

there is a radiolucent stripe that passes behind

0:17

the top of the calcaneous,

0:18

between it and the Achilles tendon.

0:21

It relates to a portion of the pre-Achilles fat pad

0:25

that extends behind and below the top of the calcaneous.

0:30

That lucency has a name.

0:32

We call it a retrocalcaneal recess.

0:36

It relates to this fat extending down

0:39

into the area of the bursa.

0:42

What occurs, however, when you have fluid within this bursa,

0:45

we have a retrocalcaneal bursitis.

0:48

That lucency normally present will be obscured

0:52

and a dome-shaped mass of fluid can be appreciated

0:56

on the radiograph.

1:00

To give you an idea now of what you might see you

1:03

with MRI imaging, look at the bottom right image,

1:05

you'll see retrocalcaneal bursitis associated

1:09

with reactive edema involving the calcaneous.

1:15

You also see altered signal

1:18

within the Achilles tendon itself,

1:21

and a superficial bursitis as well as subcutaneous edema.

1:26

This is retrocalcaneal bursitis.

1:29

Two more examples are shown here.

1:31

The upper one, again associated with altered signal

1:34

within the distal part of the Achilles tendon.

1:38

You'll see edema also within the pre-Achilles fat pad

1:41

above the bursa.

1:43

And then the bottom image is showing you

1:46

what is Haglund's syndrome.

1:48

This is the Haglund bump,

1:50

a bump on the posterior superior aspect of the calcaneous,

1:54

related and causing retrocalcaneal bursitis,

1:58

Achilles tendinosis and superficial edema,

2:02

and bursitis as well.