Bursitis

What is bursitis?

Bursitis is inflammation of a
bursa. A bursa is a closed, fluid-filled sac that works as a cushion and gliding surface
to reduce friction between tissues of the body. The major bursae (this is the plural of
bursa) are located next to the tendons near the large joints, such as in the shoulders,
elbows, hips, and knees.


Shoulder Bursitis

Bursitis is usually a temporary
condition. It may limit motion, but generally does not cause deformity.

Bursitis can happen in any bursa in
the body, but there are some common types of bursitis. These include:

  • Anterior Achilles tendon bursitis. This type of bursitis
    is also called Albert disease or retromalleolar bursitis. It’s caused by things like
    injury, disease, or shoes with rigid back support. These put extra strain on the
    lower part of the Achilles tendon. This attaches the calf muscle to the back of the
    heel. This can lead to inflammation of the bursa located where the tendon attaches to
    the heel.
  • Posterior Achilles tendon bursitis. This type of bursitis
    is in the bursa located between the skin of the heel and the Achilles tendon. This
    attaches the calf muscles to the heel. It is aggravated by walking that presses the
    soft heel tissue into the hard back support of a shoe. Walking in shoes that
    repeatedly put pressure on the heel can cause the bone to enlarge at the back of the
    heel. Examples of these shoes are high heels or pumps. This enlargement is called
    Haglund deformity.
  • Hip bursitis. This is also called trochanteric bursitis.
    Hip bursitis is often caused by injury, overuse, arthritis, or surgery. This type of
    bursitis is more common in women and middle-aged and older adults.
  • Elbow bursitis. Elbow bursitis is caused by the
    inflammation of the bursa located between the skin and bones of the elbow (olecranon
    bursa). Elbow bursitis can be caused by injury or constant pressure on the elbow. For
    example, it can happen when leaning on a hard surface.
  • Knee bursitis. Bursitis in the knee is also called
    goosefoot bursitis or Pes Anserine bursitis. The Pes Anserine bursa is located
    between the shin bone and the three tendons of the hamstring muscles, on the inside
    of the knee. This type of bursitis may be caused by not stretching before exercise,
    tight hamstring muscles, being overweight, arthritis, or out-turning of the knee or
    lower leg.
  • Kneecap bursitis. This is also called prepatellar
    bursitis. This type of bursitis is common in people who are on their knees a lot,
    such as carpet layers and plumbers.

What are the symptoms of bursitis?

The following are the most common
symptoms of bursitis. But symptoms occur a bit differently in each person. Symptoms can
include:

  • Pain
  • Tenderness
  • Limited motion
  • Swelling and redness if the inflamed bursa is close to the surface of the skin

Long-term (chronic) bursitis may
involve repeated attacks of pain, swelling, and tenderness. These may lead to the
deterioration of muscles and a limited range of motion in the affected joint.

The symptoms of bursitis may look
like other health problems. Always see a healthcare provider for a diagnosis.

How is bursitis diagnosed?

Your healthcare provider will ask
about your health history and do a physical exam. You may also need tests such as:

  • X-ray.This test uses energy beams to make pictures of
    internal tissues, bones, and organs on film.
  • MRI. This test uses large magnets, radio waves, and a
    computer to make detailed pictures of organs and structures within the body.


MRI Scan

  • Ultrasound. This test that uses high-frequency sound
    waves to look at the internal organs and tissues.
  • Aspiration. For this test, the healthcare provider uses a
    thin needle to remove fluid from the swollen bursa. The fluid is checked for
    infection or gout as causes of bursitis.
  • Blood tests. Lab tests may be done to confirm or rule out
    other conditions.

How is bursitis treated?

The treatment of any bursitis
depends on whether it involves infection.

Aseptic bursitis. This inflammation
results from soft-tissue trauma or strain injury. The bursa is not infected. Treatment
may include:

  • R.I.C.E. This stands for rest, ice,
    compression, and elevation.
  • Anti-inflammatory and pain medicines,
    such as ibuprofen or aspirin
  • Shot (injection) of a steroid into the
    affected area to help ease pain and swelling
  • Splints or braces to limit movement of
    the affected joint

Septic bursitis. The
bursa becomes infected with bacteria. This causes pain and swelling. Treatment may
include:

  • Antibiotics
  • Repeated aspiration of the infected
    fluid. A needle is used to take out the fluid.
  • Surgical drainage and removal of the
    infected bursa (bursectomy)
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