Frey C, Rosenberg Z, Shereff M J, Kim H
Foot and Ankle Service, University of Southern California, Los Angeles.
Foot Ankle. 1992 May;13(4):203-7. doi: 10.1177/107110079201300407.
The retrocalcaneal bursae, located between the posterior angle of the os calcis and the Achilles tendon, may become inflamed and hypertrophied. There are few objective tests available for the diagnosis of pain syndromes involving the hindfoot and it is often difficult to differentiate Achilles tendinitis and retrocalcaneal bursitis. Retrocalcaneal bursograms can provide further insight into chronic changes in the bursae associated with traumatic and inflammatory conditions. This report describes the anatomy of the retrocalcaneal bursa, the technique of its opacification, and the application of this technique to the diagnosis and treatment of painful hindfoot syndromes. In addition, the anatomy of the retrocalcaneal bursa was investigated further using latex casting techniques. Twelve cadaver limbs were injected with radiopaque latex casting material or renografin into the retrocalcaneal bursae. AP, lateral, and oblique radiographs were then obtained on the specimens. The size, capacity, and configuration of the postmortem bursae were measured and recorded. Subsequently, the cadaver limbs injected with the latex material were cooled and dissection was made of the retrocalcaneal bursae. The latex bursal molds were measured, graphically recorded, and photographed. Fifteen patients with signs and symptoms of retrocalcaneal bursitis and eight asymptomatic patients were selected for this study and injected with radiopaque material into the bursae. Anteroposterior, lateral, and oblique radiographs were then obtained. The size, capacity, and configuration of the retrocalcaneal bursae were measured and recorded. The anatomic characteristics noted from the latex bursal molds correlated well with the findings on bursography. Bursographic findings in patients with retrocalcaneal bursitis can provide insight into the diagnosis and clinical management of this disorder.
跟腱后滑囊位于跟骨后角与跟腱之间，可能会发生炎症和肥大。目前用于诊断涉及后足疼痛综合征的客观检查较少，且往往难以区分跟腱炎和跟腱后滑囊炎。跟腱后滑囊造影可以进一步深入了解与创伤性和炎症性疾病相关的滑囊慢性变化。本报告描述了跟腱后滑囊的解剖结构、使其显影的技术，以及该技术在诊断和治疗后足疼痛综合征中的应用。此外，还使用乳胶铸型技术对跟腱后滑囊的解剖结构进行了进一步研究。将12具尸体下肢的跟腱后滑囊注入不透射线的乳胶铸型材料或泛影葡胺。然后对标本进行前后位、侧位和斜位X线摄影。测量并记录死后滑囊的大小、容量和形态。随后，将注入乳胶材料的尸体下肢冷却，并对跟腱后滑囊进行解剖。对乳胶滑囊铸型进行测量、图像记录和拍照。选择15例有跟腱后滑囊炎体征和症状的患者以及8例无症状患者进行本研究，并向滑囊中注入不透射线的材料。然后获得前后位、侧位和斜位X线片。测量并记录跟腱后滑囊的大小、容量和形态。从乳胶滑囊铸型中观察到的解剖学特征与滑囊造影的结果相关性良好。跟腱后滑囊炎患者的滑囊造影结果可为该疾病的诊断和临床管理提供依据。
