Bursitis

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Bursitis
Bursitis Elbow WC.JPG
Example of olecranon bursitis
Specialty Orthopedics

Bursitis is the inflammation of one or more bursae (fluid filled sacs) of synovial fluid in the body. They are lined with a synovial membrane that secretes a lubricating synovial fluid. [1] There are more than 150 bursae in the human body. [1] The bursae rest at the points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying on the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem. Muscle can also be stiffened.

Contents

Signs and symptoms

3D still showing bursitis. 3D still showing Bursitis.jpg
3D still showing bursitis.

Bursitis commonly affects superficial bursae. These include the subacromial, prepatellar, retrocalcaneal, and pes anserinus bursae of the shoulder, knee, heel and shin, etc. (see below). [1] Symptoms vary from localized warmth and erythema (redness) [1] to joint pain and stiffness, to stinging pain that surrounds the joint around the inflamed bursa. In this condition, the pain usually is worse during and after activity, and then the bursa and the surrounding joint becomes stiff the next morning.[ citation needed ]

Bursitis could possibly also cause a snapping, grinding or popping sound – known as snapping scapula syndrome – when it occurs in the shoulder joint. This is not necessarily painful.

Cause

There can be several concurrent causes. 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] Infrequently, scoliosis can cause bursitis of the shoulders; however, shoulder bursitis is more commonly caused by overuse of the shoulder joint and related muscles.[ citation needed ]

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.

Diagnosis

Types

The most common examples of this condition:[ citation needed ]

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] In cases when all conservative treatment fails, surgical therapy may be necessary. In a bursectomy the bursa is cut out either endoscopically or with open surgery. The bursa grows back in place after a couple of weeks but without any inflammatory component.[ citation needed ]

See also

Related Research Articles

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<span class="mw-page-title-main">Rotator cuff</span> Group of muscles

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<span class="mw-page-title-main">Synovial bursa</span> Fluid-filled sacs which cushion the bones and muscles around joints

A synovial bursa, usually simply bursa, is a small fluid-filled sac lined by synovial membrane with an inner capillary layer of viscous synovial fluid. It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement. Bursae are found around most major joints of the body.

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<span class="mw-page-title-main">Snapping hip syndrome</span> Medical condition

Snapping hip syndrome, also referred to as dancer's hip, is a medical condition characterized by a snapping sensation felt when the hip is flexed and extended. This may be accompanied by a snapping or popping noise and pain or discomfort. Pain often decreases with rest and diminished activity. Snapping hip syndrome is commonly classified by the location of the snapping as either extra-articular or intra-articular.

<span class="mw-page-title-main">Prepatellar bursitis</span> Inflammation of the prepatellar bursa at the front of the knee

Prepatellar bursitis is an inflammation of the prepatellar bursa at the front of the knee. It is marked by swelling at the knee, which can be tender to the touch and which generally does not restrict the knee's range of motion. It can be extremely painful and disabling as long as the underlying condition persists.

<span class="mw-page-title-main">Knee effusion</span> Medical condition

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Greater trochanteric pain syndrome (GTPS), a form of bursitis, is inflammation of the trochanteric bursa, a part of the hip.

<span class="mw-page-title-main">Olecranon bursitis</span> Medical condition; swelling, redness, and pain at the tip of the elbow

Olecranon bursitis is a condition characterized by swelling, redness, and pain at the tip of the elbow. If the underlying cause is due to an infection, fever may be present. The condition is relatively common and is one of the most frequent types of bursitis.

<span class="mw-page-title-main">Subacromial bursitis</span> Medical condition

Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament, acromion, and coracoid and from the deep surface of the deltoid muscle. The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.

<span class="mw-page-title-main">Articular capsule of the knee joint</span>

The articular capsule of the knee joint is the wide and lax joint capsule of the knee. It is thin in front and at the side, and contains the patella, ligaments, menisci, and bursae of the knee. The capsule consists of an inner synovial membrane, and an outer fibrous membrane separated by fatty deposits anteriorly and posteriorly.

<span class="mw-page-title-main">Knee bursae</span>

The knee bursae are the fluid-filled sacs and synovial pockets that surround and sometimes communicate with the knee joint cavity. The bursae are thin-walled, and filled with synovial fluid. They represent the weak point of the joint, but also provide enlargements to the joint space. They can be grouped into either communicating and non-communicating bursae or, after their location – frontal, lateral, or medial.

Synovectomy is a procedure where the synovial tissue surrounding a joint is removed. This procedure is typically recommended to provide relief from a condition in which the synovial membrane or the joint lining becomes inflamed and irritated and is not controlled by medication alone. If arthritis is not controlled, it can lead to irreversible joint damage. The synovial membrane or "synovium" encloses each joint and also secretes a lubricating fluid that allows different joint motions such as rolling, folding and stretching. When the synovium becomes inflamed or irritated, it increases fluid production, resulting in warmth, tenderness, and swelling in and around the joint.

<span class="mw-page-title-main">Subacromial bursa</span>

The subacromial bursa is the synovial cavity located just below the acromion, which communicates with the subdeltoid bursa in most individuals, forming the so-called subacromial-subdeltoid bursa (SSB).

<span class="mw-page-title-main">Shoulder impingement syndrome</span> Medical condition

Shoulder impingement syndrome is a syndrome involving tendonitis of the rotator cuff muscles as they pass through the subacromial space, the passage beneath the acromion. It is particularly associated with tendonitis of the supraspinatus muscle. This can result in pain, weakness, and loss of movement at the shoulder.

<span class="mw-page-title-main">Calcific bursitis</span> Medical condition

Calcific bursitis refers to calcium deposits within the bursae. This most occurs in the shoulder area. The most common bursa for calcific bursitis to occur is the subacromial bursa. A bursa is a small, fluid-filled sac that reduces friction, and facilitates movements between its adjacent tissues. Inflammation of the bursae is called bursitis.

Ischial bursitis is inflammation of the synovial bursa located between gluteus maximus muscle and ischial tuberosity.

References

  1. 1 2 3 4 5 6 7 8 9 Vigorita, Vincent J.; Ghelman, Bernard; Mintz, Douglas (2008). Orthopaedic Pathology (Second ed.). Philadelphia: Lippincott Williams and Wilkins. p. 719. ISBN   978-0-7817-9670-5.
  2. Fauci, Anthony S.; Langford, Carol A., eds. (2010). Harrison's Rheumatology (Second ed.). McGraw-Hill Professional Publishing; Digital Edition. p. 271. ISBN   9780071741460.