Lower Extremity Bursae by Joint

Hip Bursae

  • Trochanteric bursa

    • Location: Between greater trochanter and gluteus medius/minimus tendons.

    • Signs: Lateral hip pain, tenderness over greater trochanter, pain lying on side, worse with stairs.

    • Interventions: Load management, hip abductor strengthening, gait retraining.

  • Iliopsoas (iliopectineal) bursa

    • Location: Between iliopsoas tendon and hip joint capsule.

    • Signs: Anterior hip/groin pain, snapping hip, pain with hip flexion.

    • Interventions: Stretching iliopsoas, hip mobility work, activity modification.

  • Ischiogluteal (ischial) bursa

    • Location: Between ischial tuberosity and gluteus maximus/hamstring tendon origin.

    • Signs: Pain sitting (“weaver’s bottom”), tenderness at hamstring origin.

    • Interventions: Cushioning while sitting, hamstring stretching, progressive strengthening.

Knee Bursae

  • Prepatellar bursa

    • Location: Between patella and skin.

    • Signs: Anterior knee swelling (“housemaid’s knee”), tenderness directly over patella.

    • Interventions: Offloading (knee pads), activity modification, quadriceps flexibility.

  • Infrapatellar bursa (superficial & deep)

    • Location: Superficial—between skin and patellar tendon; Deep—between patellar tendon and tibia.

    • Signs: Anterior knee pain inferior to patella, swelling with kneeling.

    • Interventions: Padding, quadriceps/hamstring flexibility, progressive loading.

  • Pes anserine bursa

    • Location: Between pes anserinus tendons (sartorius, gracilis, semitendinosus) and medial tibia.

    • Signs: Medial knee pain, worse with climbing stairs or sit-to-stand.

    • Interventions: Hamstring flexibility, hip/knee strengthening, weight management.

  • Suprapatellar bursa

    • Location: Between quadriceps tendon and femur.

    • Signs: Superior patellar swelling, mimics effusion.

    • Interventions: Activity modification, quadriceps control, treat underlying cause.

Ankle/Foot Bursae

  • Retrocalcaneal bursa

    • Location: Between Achilles tendon and posterior calcaneus.

    • Signs: Posterior heel pain, swelling anterior to Achilles tendon insertion, worse with dorsiflexion.

    • Interventions: Heel lifts, Achilles tendon loading program, footwear modification.

  • Subcutaneous calcaneal bursa (superficial Achilles bursa)

    • Location: Between skin and Achilles tendon insertion.

    • Signs: Red, swollen “pump bump” at posterior heel from shoe irritation.

    • Interventions: Padding, shoe modification, load management.

  • Other minor ankle bursae (less common, e.g., medial/lateral malleolar bursae from shoe friction).