Bursitis accounts for 0.4% of all visits to primary care clinics. The most common locations of bursitis are the subdeltoid, olecranon, ischial, trochanteric, and prepatellar bursae. The incidence of
bursitis is higher in athletes, reaching levels as high as 10% in runners. Approximately 85% of cases of septic superficial bursitis occur in men. A French study aimed at assessing the prevalence of
knee bursitis in the working population found that most cases occurred in male workers whose occupations involved heavy workloads and frequent kneeling. Mortality in patients with bursitis is very
low. The prognosis is good, with the vast majority of patients receiving outpatient follow-up and treatment.
The most common causative organism is Staphylococcus aureus (80% of cases), followed by streptococci. However, many other organisms have been implicated in septic bursitis, including mycobacteria
(both tuberculous and nontuberculous strains), fungi (Candida), and algae (Prototheca wickerhamii). Factors predisposing to infection include diabetes mellitus, steroid therapy, uremia, alcoholism,
skin disease, and trauma. A history of noninfectious inflammation of the bursa also increases the risk of septic bursitis.
Common signs and symptoms associated with infracalcaneal bursitis include redness under the heel. Pain and swelling under the heel. Pain or ache in the middle part of the underside of the heel. Heel
pain or discomfort that increases with prolonged weight-bearing activities.
A physical examination will be performed to determine if you have any signs of Achilles Bursitis or other ankle injury. He/she will look and feel the soft tissue and bones in your ankles to note any
differences between the two of them. This will identify any abnormalities, such as swelling, bone deformities, atrophied muscles, redness and/or warmth on the skin. In many cases, the first sign that
you have Achilles bursitis is swelling in the back of the foot and ankle pain.
Non Surgical Treatment
For non-infectious bursitis, the preliminary treatment starts with non-operative options such as cold compression therapy and Blood Flow Stimulation Therapy. Surgery to remove the inflamed bursa is
normally not required for bursitis, however if you fail to see improvement with the conservative treatments, your physician may recommend surgery to remove the bursa completely. Although this removes
the problem of an inflamed bursa, you are left with less cushioning in your joint which can lead to a host of other conditions.
Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can
cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition when it is persistent and cannot be relived with other treatments. During this procedure, a
surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to
remove the inflamed bursa.