Lateral malleolus bursa

Case contributed by Dr Dalia Ibrahim

Presentation

Lateral ankle swelling.

Patient Data

Age: 30 years
Gender: Male
MRI

A well defined subcutaneous cystic lesion seen at the lateral malleolus.

Bony plantar calcaneal spur.

Medial and lateral talar dome small osteochondral lesions.

Case Discussion

Malleoli do not ordinarily have anatomical bursae; rather, aberrant contact pressure and shear stresses that emerge between the bony malleoli and the skater's boot frequently result in malleolar adventitious bursae. The malleolar bony prominences have little soft tissue to buffer them from the increased pressure. The body reacts to the abnormal stress by forming an adventitious bursa at the site of the injury. Adventitial bursae have a thicker fibrous wall than regular bursae, making them more prone to inflammation.

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