Bursitis is an inflammation of a bursa. The subacromial, olecranon, prepatellar, trochanteric and infrapatellar bursae are the most commonly affected.
The following common symptomatology is seen among patients with acute, chronic and recurrent bursitis:
- Joint pain and limitation of range of motion
- Joint stiffness
- Tenderness during palpation and movement
- Swelling of bursae and joint region
- Erythema over the joint area
- Unexplained bruising of the area of the bursae
- Reddish rash around the affected joint
Most of this signs and symptoms are conservatively treated at home or in a primary health facility. Patients are however advised to seek professional help if they experience the following with bursitis:
Entire Body System
For example, don’t kneel on a swollen knee. Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the area every 3 to 4 hours for up to 20 minutes at a time to help relieve pain. [summitmedicalgroup.com]
Physical examination revealed an inguinal mass and groin pain. X-ray examination indicated destruction of the hip joint. [ncbi.nlm.nih.gov]
Acutely Ill Patient
Outpatient antibiotics may be considered in those who are not acutely ill; patients who are acutely ill should be hospitalized and treated with intravenous antibiotics. [ncbi.nlm.nih.gov]
Soft Tissue Swelling
The responses to the treatment were assessed according to the degree of fluctuation, shrinkage of the bursal sac, and soft tissue swelling. [ncbi.nlm.nih.gov]
Its clinical presentation is anterior hip pain that worsens with the extension, abduction and internal rotation of the hip. The diagnosis is confirmed by ultrasound or magnetic nuclear resonance imaging of the hip. [ncbi.nlm.nih.gov]
There are many bursae in the hip which can cause hip pain, but the greater trochanteric is the most common one. More hip bursitis stretches and exercises: ... Related Videos: Hip Pain Relief Exercises (4-Way Hip): ... [youtube.com]
Calcific bursitis of the MCL of the knee is very uncommon, but should be taken into account in differential diagnoses for medial knee pain. UGPL is proposed as a treatment for this condition. [ncbi.nlm.nih.gov]
This cause of medial knee pain can easily be overlooked as it often occurs in conjunction with other pathologies such as OA or MCL sprains. [actionsportphysio.com]
Heel pain is more common than you might think. Not surprisingly, it affects runners and ballet dancers, but it is also present in about 10 percent of the general population. About one-third of elderly people above the age of 65 have heel pain. [injurymap.com]
Continue reading… Achilles heel pain from Achilles tendinitis and bursitis, treatment and prevention Achilles tendinitis and Achilles bursitis are two types of heel pain that result from inflammation in the Achilles tendon. [belmarrahealth.com]
Heel Bursitis Heel pain can be caused by a variety of reasons. Pain in the back of the heel may be due to inflammation of the bursa located in the area where the heel bone connects to the Achilles tendon. [onhealth.com]
How to treat your knee, hip, and heel pain. Click To Tweet [runnersconnect.net]
Symptoms of bursitis may include any of the following: Joint pain and tenderness when you press around the joint Stiffness and aching when you move the affected joint Swelling, warmth or redness over the joint Pain during movement and rest Pain may spread [nlm.nih.gov]
Symptoms of bursitis are pain, decreased range of motion at the affected joint, swelling, tenderness around the bursa, warmth around the area and decreased function of the affected joint. [oaph.com]
Signs and symptoms of bursitis can include: joint pain joint stiffness joint swelling redness around the area of the joint Symptoms can vary depending on which joint is involved, what caused the irritation, and how long the person has had bursitis. [kidshealth.org]
We must, therefore, include bursitis as a possible diagnosis in patients complaining of arthralgia duruing long-term hemodialysis. [ci.nii.ac.jp]
#-varecertifikater, der udstedes i medfør af denne beslutning, skal indeholde en af følgende angivelser en hypesthesia, arthralgia, asthenia, pain, bursitis, dermatitis, headache, injection site hypersensitivity, malaise, nausea, paresthesia, postural [da.glosbe.com]
The following diagnostic procedures and tests are commonly used among patients suffering from bursitis:
Although X-ray radiographs cannot detect bursitis, this tool is most useful in ruling out any osseous pathology in the area that could mimic the symptom. Magnetic resonance imaging (MRI) and ultrasonology may be used to ascertain the diagnosis of bursitis when physical examination remains uncertain .
A fine needle may be inserted at the swollen bursae to harvest the inflamed fluids for laboratory testing. Tests may reveal the state of the inflammation and the type of organism that causes the infection within the bursae.
Olecranon bursitis secondary to Mycobacterium kansasii infection in a patient receiving infliximab for Behcet's disease. J Med Microbiol. 2009 Mar. 58:371-3. [Medline]. Brinks A, van Rijn RM, Bohnen AM, Slee GL, Verhaar JA, Koes BW, et al. [medscape.com]
Mycobacterium Avium Complex
Among these are non-tuberculous mycobacteria (NTM), with Mycobacterium avium complex being the most commonly described finding. Antimycobacterial treatment of NTM in cases of IRIS is controversial. [ncbi.nlm.nih.gov]
The majority of cases of bursitis are treated conservatively by affording adequate rest to affected area, application of ice packs, and the use of pain relievers. Where conservative management fails to offer palliative relief and resolution, the following therapies are being implored in cases of bursitis:
- Antibiotics when bursitis is found to be caused by an infective agent.
- Physical therapy to ease the pain and prevent the recurrence of the discomfort.
- Corticosteroid injections may be given directly to the bursae to afford instant relief of the pain among patients . Corticosteroid injections can be guided accurately by the use of ultrasound .
- Assistive devices. The use of walkers and walking canes may assist the patient’s mobility and reduce pain symptoms during ambulation.
- Surgery. Inflamed and infected bursae may be surgically drained to relieve the pressure and shorten the clinical course of the disease. Sometimes the whole bursa is surgically removed to permanently address the recurrent problem .
There is a very low mortality rating for bursitis. Patients with bursitis are usually treated and followed up on an outpatient basis in most medical facilities. The prognosis of bursitis is generally good for all cases.
- Repetitive pitching of a baseball
- Regular lifting of dumbbells overhead
- Extensive kneeling among monks and nuns
- Leaning on the elbows on an extended period of time
- Prolonged sitting on a hard surface
The less common causes of bursitis include rheumatoid arthritis, gouty arthritis, and infectious arthritis .
The world prevalence rate of bursitis in primary care centers is only 4 out of 1000 patient visits. The most common sites of bursitis are the shoulder, elbow, hip, thigh and knee joints. Here is a high incidence of bursitis among athletes especially among the running sports, reaching an incidence ratio of up to 1 of 10 runners. Studies have revealed that men are more prone to bursitis especially those involved in heavy workload labor that involves frequent kneeling . In septic superficial bursitis, men are more predisposed than women with a relative ratio of 17:3.
The advent of the repetitive trauma to the bursae over the joints encourages synovial cytosis. The thickening of the membranes through continuous collagen formation will increase fluid production within the joint. Chronically, this will result in granulation formation on the surface of the synovial which is followed by the onset of fibrosis. The fibrin rich fluid within the bursae can become hemorrhagic is some cases that could trigger an inflammation . Studies relates that these reactions may be mediated by cyclooxygenases, metalloproteases, and cytokines during the inflammatory process.
By convention, there are three kinds of bursitis: Acute, recurrent and chronic forms . Acute bursitis results during the sudden thickening of the synovial fluid causing pain during movement. Chronic bursitis results with long standing pain causing the weakening of the joint muscles, tendons, and ligaments as a complication. The recurrent forms are those sporadic and intermittent attacks of acute bursitis in a period of time like those seen in swimmers, gymnasts, and weight lifters .
There are some modifiable factors that can be resorted to prevent the recurrence of bursitis and allay its symptoms. The use of knee pads can greatly reduce the friction of the kneeling surface towards the afflicted bursa. Avoidance of lifting excessive weight loads will prevent the undue pressure on the hips and knee bursae. For those involved in repetitive tasks, frequent breaks may be needed to afford some rest on the bursae and joints involved. Changing one’s position frequently while doing repetitive tasks may also do the trick efficiently. Athletes should do pre-activity warm ups and stretching to strengthen the joints and the muscles around the bursae.
Bursitis is a clinical disease characterized by acute and chronic inflammation of the bursa. This inflammation is usually caused by repetitive trauma or friction, infections, and crystal depositions. Patients usually complain of pain during movement, tenderness, and swelling.
Bursitis is a disorder described as a painful swelling and inflammation of the fluid filled sacs that cushions the bone, muscles and tendons called bursae. These bursae are found in some of the major joints of the body including the shoulder, hip, elbow and the knee joints. Bursitis commonly occurs on joints that do frequent and repetitive movements. In bursitis, the synovial lining histologically thickens and produces excessive fluid that leads to localized swelling and tenderness . Most of the cases are resolved within weeks after resting the affected site or by giving simple pain control measures.
The diagnosis of bursitis can be made by proper physical examination most of the times. Imaging studies sometimes can give a better clue. Specific diagnosis of the causative agent can sometimes be made by laboratory examination of bursa aspirate.
- Sheon RP, Moskowitz RW, Goldberg VM. Soft Tissue Rheumatic Pain: Recognition, Management, Prevention. 3rd ed. Baltimore: Williams and Wilkins; 1996.
- Torralba KD, Quismorio FP Jr. Soft tissue infections. Rheum Dis Clin North Am. Feb 2009; 35(1):45-62.
- Le Manac'h AP, Ha C, Descatha A, Imbernon E, Roquelaure Y. Prevalence of knee bursitis in the workforce. Occup Med (Lond). Jul 9 2012.
- Hirji Z, Hunjun JS, Choudur HN. Imaging of the bursae. J Clin Imaging Sci. 2011; 1:22.
- Reilly JP, Nicholas JA. The chronically inflamed bursa. Clin Sports Med. Apr 1987; 6(2):345-70.
- Blankstein A, Ganel A, Givon U, Mirovski Y, Chechick A. Ultrasonographic findings in patients with olecranon bursitis. Ultraschall Med. Dec 2006; 27(6):568-71.
- Guanche CA. Clinical update: MR imaging of the hip. Sports Med Arthrosc. Mar 2009; 17(1):49-55.
- Rowand M, Chambliss ML, Mackler L. Clinical inquiries. How should you treat trochanteric bursitis? J Fam Pract. Sep 2009; 58(9):494-500.
- D'Agostino MA, Schmidt WA. Ultrasound-guided injections in rheumatology: actual knowledge on efficacy and procedures. Best Pract Res Clin Rheumatol. Apr 2013; 27(2):283-94.
- Slawski DP, Howard RF. Surgical management of refractory trochanteric bursitis. Am J Sports Med. Jan-Feb 1997; 25(1):86-9.