bursitis

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Any inflammation of a bursa. Bursae are synovial pouches, positioned to minimize friction between moving parts of the body. Bursitis most often occurs near the shoulder, hip, elbow, or knee. See also Bursa; Joint (anatomy).

Inflammatory changes in bursae produce acute or chronic swelling, an increase in the fluid content, and variable degrees of pain and tenderness. Acute bursitis may be septic (caused by microorganisms) or nonseptic. Nonseptic bursitis can be further subdivided into idiopathic (of unknown cause), traumatic, and crystal-induced bursitis. Septic bursitis may result from direct penetration by microorganisms through medical instrumentation or trauma; rarely, microorganisms may reach bursae through the blood. Most cases of bursitis are nonseptic; they may result from trauma or physical stress. In chronic bursitis, the wall of the bursa becomes thickened, shaggy, and irregular, with calcium deposits commonly being present.

The treatment depends on whether the bursitis is septic or nonseptic. Septic bursitis is most commonly due to Staphylococcus aureus and requires prompt administration of appropriate antibiotics and repeated drainage of fluid containing pus. Nonseptic bursitis can be treated conservatively by withdrawal of fluid and administration of nonsteroidal, anti-inflammatory drugs. Crystal-induced nonseptic bursitis is most frequently due to gout and usually responds well to drug therapy. Avoidance of trauma can help to prevent occupation-related cases of bursitis. Most cases of bursitis have a favorable prognosis. See also Connective tissue; Gout.

An inflammation of a bursa that results in a form of internal blistering causing the bursal sac to become inflated with fluid. Bursitis may be caused by repeated mechanical irritation (frictional bursitis), substances formed as a result of inflammation or degeneration of tissue (chemical bursitis), or bacterial infection (septic bursitis). Treatment may include diathermy and the topical application of anti-inflammatory drugs. Chronic bursitis may require surgical excision.

Inflammation of a bursa. Common locations of bursitis include the joints of the shoulder, knee, and elbow.

Inflammation of a bursa. Acute bursitis comes on suddenly; severe pain and limitation of motion of the affected joint are the principal signs. See also hygroma, intra-abdominal abscess.
Chronic bursitis may follow the acute attacks. There is continued pain and limitation of motion around the joint.

• atlantal b. — see poll evil.
• carpal b. — see carpal hygroma.
• trochanteric b. — inflammation, in the horse, of the bursa between the tendon of the middle gluteal muscle and the major trochanter of the femur or its cartilage. Causes lameness and atrophy of muscles in long-standing cases. Called also whirlbone lameness.

  Traumatic bursitis (capped hock) in horse. By permission from Knottenbelt DC, Pascoe RR, Diseases and Disorders of the Horse, Saunders, 2003.

• Afflictions and Conditions - bursitis: inflammation of small fibrous sacs lined with synovial membrane, due to injury or infection, characterized by pain and stiffness in joints

Bursitis
Classification and external resources
Example of Elbow Bursitis
ICD-10	M70-M71
ICD-9	727.3
DiseasesDB	31623
MedlinePlus	000419
eMedicine	emerg/74
MeSH	D002062

Bursitis is the inflammation of one or more bursae (small sacs) of synovial fluid in the body. 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 upon the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem.

Contents 1 Signs and symptoms 2 Cause 2.1 Examples 3 Treatment 4 See also 5 References 6 External links

Signs and symptoms

Bursitis symptoms vary from local joint pain and stiffness, to burning 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 become stiff the next day in the morning.

Cause

Bursitis is commonly caused by repetitive movement and excessive pressure. Elbows and knees are the most commonly affected. Inflammation of the bursae might also be caused by other inflammatory conditions such as rheumatoid arthritis. Although infrequent, scoliosis might cause bursitis of the shoulders; however, shoulder bursitis is more commonly caused by overuse of the shoulder joint and related muscles.^[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 reason is unknown. It can also be associated with some chronic systemic diseases.

Examples

The most common examples of this condition:

• Prepatellar bursitis, "housemaid's knee"
• Infrapatellar bursitis, "clergyman's knee"
• Trochanteric bursitis, giving hip pain
• Olecranon bursitis, "student's elbow", characterised by pain and swelling in the elbow
• Subacromial bursitis, giving shoulder pain

Treatment

Bursae that are not infected can be treated 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 contraindicated because compression would create more friction on movement (passive and active). Advanced massage therapy techniques can also be employed to help with the inflammatory process of bursitis.

Bursae that are infected requires further investigation and antibiotic therapy. 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.

See also

Wikimedia Commons has media related to: Bursitis

• Calcific bursitis

References

1. ^ "Shoulder Bursitis". http://www.treatment-for.com/shoulder-bursitis-treatment.htm. 

External links

• American College of Rheumatology
• Bursitis treatment from NHS Direct
• General Bursitis Information at About.com
• Information from the Mayo Clinic
• Bursitis information and treatment options from Bursitis.ws
• Bursitis Causes, Symptoms, Treatment, Types and Diagnosis from MedicineNet.com

v d e Soft tissue disorders / Rheumatism / Connective tissue arthropathy (M65–M79, 725–728) Capsular joint Synoviopathy Synovitis/Tenosynovitis (Calcific tendinitis, Stenosing tenosynovitis, Trigger finger, DeQuervain's syndrome) · Transient synovitis · Ganglion cyst osteochondromatosis (Synovial osteochondromatosis) · Plica syndrome villonodular synovitis (Giant cell tumor of the tendon sheath) Bursopathy Bursitis (Olecranon, Prepatellar, Trochanteric, Subacromial) · Synovial cyst (Baker's cyst) · Calcific bursitis Noncapsular joint Ligamentopathy Ligamentous laxity · Hypermobility Enthesopathy/Enthesitis (and general tendinopathy) upper limb (Adhesive capsulitis of shoulder, Impingement syndrome Rotator cuff tear, Golfer's elbow, Tennis elbow) lower limb (Iliotibial band syndrome, Patellar tendinitis, Achilles tendinitis, Calcaneal spur, Metatarsalgia) · Bone spur other/general: Tendinitis · Tendinosis Nonjoint Fasciopathy Fasciitis: Plantar · Nodular · Necrotizing · Eosinophilic Fibromatosis/contracture Dupuytren's contracture · Plantar fibromatosis · Aggressive fibromatosis · Knuckle pads M: JNT anat(h/c, u, t, l)/phys noco(arth/defr/back/soft)/cong, sysi/epon, injr proc, drug(M01C, M4) M: MUS, DF+DRCT anat (h/n, u, t/d, a/p, l)/phys/devp/hist noco(m, s, c)/cong(d)/tumr, sysi/epon, injr proc, drug (M1A/3)

v d e Inflammation Acute Plasma derived mediators Bradykinin · complement (C3, C5a, MAC) · coagulation (Factor XII, Plasmin, Thrombin) Cell derived mediators preformed: Lysosome granules · vasoactive amines (Histamine, Serotonin) synthesized on demand: cytokines (IFN-γ, IL-8, TNF-α, IL-1) · eicosanoids (Leukotriene B4, Prostaglandins) · Nitric oxide · Kinins Chronic Macrophage · Epithelioid cell · Giant cell · Granuloma Processes Traditional: Rubor · Calor · Tumor · Dolor (pain) · Functio laesa Modern: Acute-phase reaction/Fever · Vasodilation · Increased vascular permeability · Exudate · Leukocyte extravasation · Chemotaxis Specific locations Nervous CNS (Encephalitis, Myelitis) · Meningitis (Arachnoiditis) · PNS (Neuritis) · eye (Dacryoadenitis, Scleritis, Keratitis, Choroiditis, Retinitis, Chorioretinitis, Blepharitis, Conjunctivitis, Iritis, Uveitis) · ear (Otitis, Labyrinthitis, Mastoiditis) Cardiovascular Carditis (Endocarditis, Myocarditis, Pericarditis) · Vasculitis (Arteritis, Phlebitis, Capillaritis) Respiratory upper (Sinusitis, Rhinitis, Pharyngitis, Laryngitis) · lower (Tracheitis, Bronchitis, Bronchiolitis, Pneumonitis, Pleuritis) · Mediastinitis Digestive mouth (Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis, Cheilitis, Pulpitis, Gnathitis) · tract (Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Caecitis, Appendicitis, Proctitis) · accessory (Hepatitis, Cholangitis, Cholecystitis, Pancreatitis) · Peritonitis Integumentary Dermatitis (Folliculitis) · Cellulitis · Hidradenitis Musculoskeletal Arthritis · Dermatomyositis · soft tissue (Myositis, Synovitis/Tenosynovitis, Bursitis, Enthesitis, Fasciitis, Capsulitis, Epicondylitis, Tendinitis, Panniculitis) Osteochondritis: Osteitis (Spondylitis, Periostitis) · Chondritis Urinary Nephritis (Glomerulonephritis, Pyelonephritis) · Ureteritis · Cystitis · Urethritis Reproductive female: Oophoritis · Salpingitis · Endometritis · Parametritis · Cervicitis · Vaginitis · Vulvitis · Mastitis male: Orchitis · Epididymitis · Prostatitis · Balanitis · Balanoposthitis pregnancy/newborn: Chorioamnionitis · Omphalitis Endocrine Insulitis · Hypophysitis · Thyroiditis · Parathyroiditis · Adrenalitis Lymphatic Lymphangitis · Lymphadenitis

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