Retrocalcaneal Heel Bursitis N085

Current RMA Instruments:

Changes from Previous Instruments:

ICD coding:

• ICD-10-AM:    M71.59

Brief description:

• Retrocalcaneal heel bursitis involves inflammation of the deep Achilles bursa, located between the distal Achilles tendon and the calcaneus (heel) bone. This bursa is a fluid filled sac which reduces friction between the Achilles tendon and the calcaneus during movement. 

The Achilles tendon is associated with two bursae that can become inflamed or irritated:

• Deep to the Achilles tendon – covered by this SOP.

• Superficial to the Achilles tendon – not covered by this SOP but by the ‘Posterior adventitial heel bursitis’ SOP.

Both bursae can become affected simultaneously in conditions like Haglund's syndrome, resulting in pain, swelling and discomfort at the back of the heel. 

Confirming the diagnosis:

Diagnosing this condition involves clinical history and examination findings consistent with retrocalcaneal heel bursitis. Ultrasound or MRI imaging studies are often useful in confirming this diagnosis and ruling out other conditions such as Achilles tendinopathy. 

To establish the diagnosis, the assessment and/or management may involve consultation with an orthopaedic surgeon or sports physician. However, general practitioners are commonly able to confirm this diagnosis with imaging results and the consistent clinical history. 

Additional diagnoses covered by these SOPs

• Achilles bursitis if involving the deep bursa
• Retro-Achilles bursitis
• Deep heel bursitis

Conditions not covered by these SOPs   

• Posterior adventitial heel bursitis *

• Superficial Achilles heel bursitis * - Posterior adventitial heel bursitis

• Superficial retro- Achilles heel bursitis * - Posterior adventitial heel bursitis

• Subcutaneous calcaneal bursitis * - Posterior adventitial heel bursitis

* another SOP applies  - the SOP has the same name unless otherwise specified

^# non-SOP condition

Clinical onset

The clinical onset refers to the earliest point in time, as identified by the treating doctor, when symptoms and signs consistent with the diagnosis of retrocalcaneal heel bursitis were observed, prior to its formal confirmation. 

Clinical worsening

When considering any issues concerning possible clinical worsening, it is important to ascertain whether the clinical worsening is out of keeping with the natural history of the underlying pathology. Retrocalcaneal heel bursitis is usually an episodic condition but clinical worsening may occur if the condition is left without appropriate management or if aggravating factors are permitted to persist. Timely intervention (e.g. addressing the underlying cause(s), medications, orthotics, changing footwear, physiotherapy etc) and adherence to treatment can prevent worsening and progression of retrocalcaneal heel bursitis.