Retrocalcaneal heel bursitis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 88 of 2024

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting retrocalcaneal heel bursitis or death from retrocalcaneal heel bursitis with the circumstances of a person's relevant service:

1. (1)
   Running or jogging an average of at least 30 kilometres per week for the 4 weeks before clinical onset or clinical worsening;
2. (2)
   undertaking weight bearing exercise involving repeated activity of the ankle joint on the affected side for: (a) a minimum intensity of 5 METS; and (b) for at least 4 hours per week; and (c) for at least the 4 weeks before clinical onset or clinical worsening;

   Note: Examples of weight bearing exercise involving repeated activity of the ankle joint at a minimum intensity of 5 METS include marching, playing basketball, football, volleyball, and track and field (especially those activities that involve jumping).

   Note: MET (metabolic equivalent) is a unit of measure of the level of physical capability of the cardiorespiratory system. For example, 1 MET = cardiorespiratory effort associated with a person sitting, 3-4 METs = cardiorespiratory effort associated with a person walking at average walking pace (5 km/h) or light gardening.

3. (3)
   having one of the following systemic arthritic diseases at the time of clinical onset or clinical worsening: (a) ankylosing spondylitis; (b) Behcet syndrome; (c) enteropathic spondyloarthropathy (arthritis associated with inflammatory bowel disease); (d) gout; (e) pseudogout (calcium pyrophosphate dihydrate) or crystal-induced arthropathy from the deposition of calcium hydroxyapatite or calcium oxalate; (f) psoriatic arthropathy; (g) reactive arthritis; (h) rheumatoid arthritis; or (i) undifferentiated spondyloarthropathy;
4. (4)
   having chronic renal failure within the 10 years before clinical onset or clinical worsening as indicated by: (a) a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least 3 months; or (b) undergoing chronic dialysis for renal failure;
5. (5)
   having a bacterial infection of the affected retrocalcaneal bursa at the time of clinical onset or clinical worsening;
6. (6)
   wearing footwear that causes excessive pressure on the posterior aspect of the heel of the affected foot, at the time of clinical onset or clinical worsening;
7. (7)
   inability to obtain appropriate clinical management for retrocalcaneal heel bursitis before clinical worsening;