Bursitis

Bursitis
Other names	bone disfiguration
Example of olecranon bursitis
Specialty	Orthopedics
Symptoms	Wide ranging including localized warmth and erythema (redness) [1] and/or joint pain and stiffness and/or stinging pain that surrounds the joint around the inflamed bursa
Types	Calcific bursitis; chronic bursitis, olecranon bursitis
Causes	Trauma, auto-immune disorders, infection, iatrogenic (medicine-related) factors can all cause bursitis, [1] and/or repetitive movement and excessive pressure.
Treatment	Rest, ice, elevation, physiotherapy, anti-inflammatory drugs and/or pain medication

Bursitis is the inflammation of one or more bursae in the body. Bursae are small sacs filled with lubricating synovial fluid that decrease friction at contact points between bones, skin, tendons, and muscle. Irritation of the bursae usually occurs as a result of trauma or overuse, but may also occur due to systemic illnesses. While there are more than 150 bursae in the human body, common sites of bursitis include the shoulder, elbow, hip, and knee. Bursitis is associated with redness, swelling, and pain. Bursitis is typically treated with conservative management (e.g. rest, compression, NSAIDs), but additional evaluation and treatment (e.g. steroid injections or surgery) may be required if initial management fails. ^{[2] [3]}

Signs and symptoms

3D image showing normal bursa (left) and bursitis (right)

Bursitis presents with redness and swelling over the affected region. It is typically painful, and can be associated with decreased range of motion. ^{[2] [3]}

Cause

There can be several concurrent causes, most common are repetitive motions or positions that put pressure on the bursae around a joint. ^[3] Trauma, auto-immune disorders, infection and iatrogenic (medicine-related) factors can all cause bursitis. ^[1] Bursitis is commonly caused by repetitive movement and excessive pressure. Shoulders, elbows and knees are the most commonly affected. Inflammation of the bursae may also be caused by other inflammatory conditions such as rheumatoid arthritis, scleroderma, systemic lupus erythematosus, and gout. Immune deficiencies, including HIV and diabetes, can also cause bursitis. ^[1]

Traumatic injury is another cause of bursitis. The inflammation irritates because the bursa no longer fits in the original small area between the bone and the functionary muscle or tendon. When the bone increases pressure upon the bursa, bursitis results. Sometimes the cause is unknown. It can also be associated with various other chronic systemic diseases.^{[ citation needed ]}

Diagnosis

The primary evaluation of suspected bursitis should include a thorough history and physical exam. Imaging it not required to diagnosis bursitis, but can may still have utility to identify underlying cause (e.g. radiograph to reveal bony abnormalities) or support a suspected diagnosis (e.g. US or MRI to show fluid collections or soft tissue swelling). ^{[2] [3]}

Treatment

It is important to differentiate between infected and non-infected bursitis. People may have surrounding cellulitis and systemic symptoms include a fever. The bursa should be aspirated to rule out an infectious process. ^[1]

Bursae that are not infected can be treated symptomatically with rest, ice, elevation, physiotherapy, anti-inflammatory drugs and pain medication. Since bursitis is caused by increased friction from the adjacent structures, a compression bandage is not suggested because compression would create more friction around the joint. Chronic bursitis can be amenable to bursectomy and aspiration. ^[1] Bursae that are infected require further investigation and antibiotic therapy. Steroid therapy may also be considered. ^[1]

See also

• Calcific bursitis
• Snapping scapula syndrome

References

1. Vigorita, Vincent J.; Ghelman, Bernard; Mintz, Douglas (2008). Orthopaedic Pathology (Second ed.). Philadelphia, Pennsylvania: Lippincott Williams and Wilkins. p. 719. ISBN   978-0-7817-9670-5.
2. Kellermann, Rick D.; Rakel, David; Heidelbaugh, Joel J.; Lee, Ernestine M., eds. (2025). Conn's current therapy 2025: Rick D. Kellermann, David P. Rakel, Joel J. Heidelbaugh, Ernestine M. Lee. Philadelphia: Elsevier. ISBN   978-0-443-12181-4.
3. "Bursitis - Symptoms and causes". Mayo Clinic. Retrieved 2026-01-16.

External links

• Bursitis treatment from NHS Direct
• Questions and Answers about Bursitis and Tendinitis  – US National Institute of Arthritis and Musculoskeletal and Skin Diseases