-IBIS-1.5.0-
tx
musculoskeletal system
bursitis
diagnoses
definition and etiology
definition:
Acute or chronic inflammation in a bursa.
etiology: Bursae are thin-walled sacs lined with synovial fluid and function to lubricate and ease the movement of the tendons and muscles over bony prominences. Causes of bursitis include trauma; systemic disease (such as arthritis or RA); gout; repetitive or excessive frictional force; or infection.
Most commonly, bursitis is seen in the shoulder, although many other joints can become inflamed: olecranon, pre- or suprapatellar, trochanteric, ischial, anserine.
signs and symptoms
acute:
Pain.
Decreased range of motion.
Local tenderness on palpation.
Swelling and redness is visualized if the bursa is superficial (e.g. olecranon and prepatellar)
chronic:
Thickened bursa wall.
Formation of adhesion, calcareous deposits, muscle atrophy from not using it.
Various degrees of pain, tenderness, swelling, muscle weakness.
Typically, the range of motion is quite decreased.
shoulder:
Bicipital tendinitis: Tenderness over the bicipital groove and pain with elbow flexion.
Subacromial bursitis: Pain and tenderness locally and pain with all movements, especially rotation.
Supraspinatus tendinitis: No rotational pain but pain when abduction reaches 40 degrees.
lab findings:
x-rays may show inflammatory signs
course and prognosis
Unless treatment occurs, the bursitis tends to become chronic or consistently recur. Bursitis may cause splinting muscle spasms which further compress and irritate the bursa. Advanced disease can lead to a frozen shoulder from marked collagenous adhesion formation.
differential diagnosis
Muscle or tendon tears.
Ligamentous injury.
Cellulitis.
TB.
Osteomyelitis.
footnotes