bursitis

What is Bursitis?

Bursitis is a painful condition that affects the small, fluid-filled sacs called bursae (bur-SEE) that cushion the bones, muscles, and other tissue inside your body [1]. A bursa is a fluid-filled sac that cushions a joint, and when it becomes inflamed, the condition is known as bursitis [2].

Causes of Bursitis

Bursitis can be caused by direct trauma, recurrent minor injury, infection, or crystal deposition diseases. It may also result from overuse or repetitive motion, which can cause inflammation in the affected area [8].

Symptoms of Bursitis

The symptoms of bursitis include painful swelling of a bursa, one of the fluid-filled sacs that cushion spaces between bones, muscles, and other tissue inside your body [3]. The pain is usually localized to the affected area and can be severe.

Types of Bursitis

Bursitis can occur in various parts of the body, including the knee, shoulder, elbow, and hip. Knee bursitis, for example, is a condition in which one or more small fluid-filled sacs near the knee joint become inflamed [7].

Treatment of Bursitis

The treatment of bursitis usually involves rest, ice, compression, and elevation (RICE) to reduce pain and inflammation. In some cases, medication may be prescribed to manage symptoms. In severe cases, surgery may be necessary to drain the affected bursa or repair any damaged tissue [not provided in context].

References

[1] Aug 25, 2022 — Bursitis (bur-SY-tis) is a painful condition that affects the small, fluid-filled sacs — called bursae (bur-SEE) — that cushion the bones, ...

[2] A bursa is a fluid-filled sac that cushions a joint. When a bursa becomes inflamed, the condition is known as bursitis.

[3] Bursitis is painful swelling of a bursa, one of the fluid-filled sacs that cushion spaces between bones, muscles and other tissue inside your body.

[7] Mar 2, 2024 — Knee bursitis is a condition in which one or more small fluid-filled sacs near the knee joint become inflamed. The sacs are called bursae.

[8] Bursitis is inflammation of a synovial-lined bursa and may result from direct trauma, recurrent minor injury, infection, or crystal deposition diseases.

Common Signs and Symptoms of Bursitis

Bursitis can manifest in various ways, depending on the location and severity of the inflammation. Here are some common signs and symptoms to look out for:

• Pain: Pain is the most common symptom of bursitis, often described as dull, achy, or sharp (1). It may build up slowly or be sudden and severe, especially if you have calcium deposits in the area (11).
• Tenderness: The affected area may feel tender to the touch, warmer than surrounding skin, and swollen (5).
• Swelling: Swelling is a common symptom of bursitis, which can make the joint or surrounding area appear larger than usual (8).
• Stiffness: Stiffness and aching when moving the affected joint are also common symptoms (8).
• Limited mobility: Bursitis can cause a loss of range of motion in the affected joint, making it difficult to move or perform daily activities.
• Warmth: The affected area may feel warm to the touch due to inflammation.

Location-Specific Symptoms

The symptoms of bursitis can vary depending on the location of the inflammation. For example:

• Knee bursitis: Knee bursitis symptoms include warmth, tenderness, and swelling in the knee joint (4).
• Hip bursitis: Hip bursitis symptoms include pain that worsens after activity, hip swelling, and limited mobility (9).

When to Seek Medical Attention

If you experience any of the following symptoms, seek medical attention:

• Sudden and severe pain
• Swelling or redness in the affected area
• Difficulty moving the affected joint
• Fever or chills

It's essential to consult a healthcare professional for proper diagnosis and treatment. They can assess your condition, provide a diagnosis, and recommend the best course of treatment.

References:

(1) [2] (5) [10] (8) [9] (11)

Diagnostic Tests for Bursitis

Bursitis can be diagnosed through a combination of physical examination, medical history, and various diagnostic tests. Here are some of the common tests used to diagnose bursitis:

• Physical Examination: A thorough physical examination by a healthcare professional is essential in diagnosing bursitis. The doctor will examine the affected area, check for swelling, redness, and tenderness, and assess the range of motion.
• Imaging Tests: Imaging tests such as X-rays, ultrasound, MRI (Magnetic Resonance Imaging), and CT scans can help confirm the diagnosis of bursitis. These tests can show the presence of fluid in the bursa, inflammation, or other abnormalities that may indicate bursitis [1][2].
• Blood Tests: Blood tests can measure various factors in your blood chemistry to test for conditions such as bursitis [3]. However, these tests are not specific to bursitis and can only help rule out other conditions.
• Aspiration: Aspiration involves removing fluid from the affected bursa using a needle. This procedure can provide a sample of fluid that can be analyzed in a laboratory to confirm the diagnosis of bursitis [4].
• Other Tests: Other tests such as arthrogram, CT scan, and bone scans may also be performed to rule out other conditions or to confirm the diagnosis of bursitis [5][6].

It's worth noting that no single test can definitively diagnose bursitis. A combination of physical examination, medical history, and diagnostic tests is usually necessary to make an accurate diagnosis.

References:

[1] Aug 25, 2022 — Imaging tests can help exclude other causes of discomfort. [2] What tests are done to diagnose bursitis? · X-rays to rule out other conditions. · Ultrasound or MRI (magnetic resonance imaging) to detect swollen bursae. [3] Blood tests can measure and evaluate a variety of factors in your blood chemistry to test for conditions such as bursitis. [4] Diagnostic procedures may include x-ray, laboratory tests, CT scan, MRI, arthrogram, blood tests and aspiration. [5] Your doctor might order imaging tests such as x-ray, MRIs, ultrasounds, or bone scans. Ultrasound and MRI specifically are used to confirm the diagnosis when necessary. [6] A diagnosis may include investigating and ruling out any other possible causes. Tests performed to confirm or rule out bursitis may include: physical examination, X-rays, laboratory tests, CT scan, MRI, arthrogram, blood tests, and aspiration.

Treatment Options for Bursitis

Bursitis can be treated using various methods, including medication, injections, and physical therapy.

• Medications: Over-the-counter (OTC) medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, can help reduce pain and inflammation. These medications come in pill form or as a cream that can be applied directly to the affected area [2].
• Intrabursal Steroid Injections: Injecting corticosteroids into the bursa can provide quick relief from pain and inflammation. This treatment is usually considered when other methods have not been effective [1][7].
• Bursal Aspiration: Removing fluid from the bursa through a procedure called bursal aspiration can help reduce pressure and alleviate symptoms.
• Physical Therapy: Engaging in physical therapy, such as exercises to strengthen surrounding muscles and improve range of motion, can also be beneficial.

Prescribed Medications

Some medications are specifically prescribed for treating bursitis. For example:

• Naproxen (Anaprox DS, Naprelan, Naprosyn, EC-Naprosyn, Aleve) is used to relieve mild to moderately severe pain and inhibit inflammatory responses [5].

Combination Therapy

Treatment plans often involve a combination of these methods. Bursa injections are commonly combined with rehabilitation, depending on the body area affected by bursitis [8].

Differential Diagnosis of Bursitis

Bursitis, an inflammation of a fluid-filled sac (bursa) that cushions joints and reduces friction between bone and soft tissue, can be caused by various factors. When diagnosing bursitis, it's essential to consider other possible conditions that may present similar symptoms.

Causes of Bursitis

• Infection: Septic bursitis is a bacterial infection of the bursa, which can cause severe pain and swelling.
• Chronic Overuse/Trauma: Repetitive motion or direct blows to the affected area can lead to bursitis.
• Gout: A type of arthritis characterized by sudden, severe joint pain, often accompanied by redness and swelling.
• Rheumatoid Arthritis (RA): An autoimmune disorder that causes inflammation in the joints, leading to pain, stiffness, and swelling.
• Trauma with Hemobursa: Bleeding into the bursa can cause pain and swelling.

Other Conditions to Consider

• Tendonitis: Inflammation of the tendons, which connect muscles to bones.
• Cellulitis: A bacterial skin infection that can cause redness, swelling, and pain.
• Osteoarthritis: Wear and tear on joint cartilage and underlying bone, leading to pain and stiffness.

Diagnosis

A careful medical history and physical examination are crucial in diagnosing bursitis. Imaging tests, such as X-rays or ultrasound, may be used to rule out other conditions like bone problems or arthritis. In some cases, drawing tissue from a swollen area can help confirm the diagnosis.

References:

• [1] Other causes include acute trauma/hemorrhage, inflammatory disorders such as gout or rheumatoid arthritis, and infection (septic bursitis).
• [3] Diagnosis calls for a careful medical history and physical exam. may be used to rule out bone problems or arthritis.
• [6] A wide range of conditions can cause bursitis, including infection (septic bursitis), chronic overuse/trauma, gout, rheumatoid arthritis (RA), ...
• [7] The differential diagnosis includes gout, pseudogout, arthritis, and trauma with hemobursa. An overlying cellulitis may be confused with bursitis.
• [8] Differentiating Bursitis from other Diseases · Tendonitis · Cellulitis · Osteoarthritis · Gout · Rheumatoid Arthritis (RA) · Septic arthritis ...