Adventitious bursitis refers to inflammation associated with adventitious bursae.
Adventitious bursae are not permanent native bursae. They can develop in adulthood at sites where subcutaneous tissue becomes exposed to high pressure and friction.
When present in the foot, patients may present with metatarsalgia 6.
These begin when pre-existing small fluid spaces coalesce in loose connective tissue. The walls then progressively become differentiated from the adjacent connective tissue and a well-defined fluid-filled cavity is formed, which is lined by synovium-like columnar cells. Unlike permanent bursae, they lack a mesothelial lining.
- foot and ankle region: typical site and usually adjacent to bony prominences
- medial aspect of the first metatarsal head
- towards the plantar aspect of the metatarsal heads
- overlying amputation stumps 3
A region of superficial swelling with a fluid (anechoic) tract corresponding to friction sites in typical locations can be seen.
May demonstrate an ill-defined lesion located in the subcutaneous fat. Typical signal characteristics are that of fluid:
- T1: low signal
- high signal
- may have intralesional string- or band-like low-signal structures
- 1. Van Hul E, Vanhoenacker F, Van Dyck P et-al. Pseudotumoural soft tissue lesions of the foot and ankle: a pictorial review. Insights Imaging. 2011;2 (4): 439-452. doi:10.1007/s13244-011-0087-2 - Free text at pubmed - Pubmed citation
- 2. Jensen B, Leykum B, Fiorito J et-al. Adventitious bursae underlying chronic wounds: another possible deterrent to healing. Eplasty. 2012;12: e14. Free text at pubmed - Pubmed citation
- 3. Ahmed A, Bayol MG, Ha SB. Adventitious bursae in below knee amputees. Case reports and a review of the literature. Am J Phys Med Rehabil. 1994;73 (2): 124-9. Pubmed citation
- 4. Foisneau-Lottin A, Martinet N, Henrot P et-al. Bursitis, adventitious bursa, localized soft-tissue inflammation, and bone marrow edema in tibial stumps: the contribution of magnetic resonance imaging to the diagnosis and management of mechanical stress complications. Arch Phys Med Rehabil. 2003;84 (5): 770-7. Pubmed citation
- 5. Studler U, Mengiardi B, Bode B et-al. Fibrosis and adventitious bursae in plantar fat pad of forefoot: MR imaging findings in asymptomatic volunteers and MR imaging-histologic comparison. Radiology. 2008;246 (3): 863-70. doi:10.1148/radiol.2463070196 - Pubmed citation
- 6. Kier R, Abrahamian H, Caminear D et-al. MR arthrography of the second and third metatarsophalangeal joints for the detection of tears of the plantar plate and joint capsule. AJR Am J Roentgenol. 2010;194 (4): 1079-81. doi:10.2214/AJR.09.3393 - Pubmed citation