Retrocalcaneal Bursa

This is a free supplement to The Resident’s Manual of Ultrasound-Guided Procedures.

Diagnostic evaluation of the retrocalcaneal bursa.

These videos are from a low-quality handheld ultrasound machine.

It’s incredibly important that you are not within the Achilles tendon when you do this injection. There is a nonzero risk of Achilles tendon rupture with this injection, even when done properly.

The hyperechoic signal just deep to the Achilles tendon is the tiny amount of air in the needle. Even if you expel the air from the syringe, there will still be some left within the needle. You can see the artifactual shadow it creates penetrating the surface of the calcaneus.