Bursitis

– An acute or chronic inflammation of a bursa.

Causes and Incidence

The etiology of most bursitis is unknown, although trauma, overuse, arthritis, gout, and infection have been implicated.

Disease Process

Exposure to an etiologic agent causes irritation of the bursal sac, which becomes inflamed, edematous, enlarged, and tender.

Symptoms

Localized pain, redness, heat, swelling, and tenderness around a bony prominence (most often the shoulder) accompanied by limited range of motion (ROM).

Potential Complications

Repeated inflammation leads to a chronic condition marked by adhesions and calcifications in the bursal sac, permanent muscle atrophy, adhesion capsulitis, and reduced ROM.

Diagnostic Tests

The diagnosis depends on clinical evaluation and a pattern of the aforementioned symptoms or a history of trauma, repetitive motion, gout, or arthritis. With chronic bursitis, x-rays may show calcifications.

Treatments

Surgery
Needle aspiration of fluid in sac; excision of calcium deposits; removal of bursal sac.

Drugs
Nonsteroidal antiinflammatory agents for pain and inflammation; corticosteroid injections into bursa and surrounding tendons.

General
Rest and immobilization of joint; passive ROM exercises as pain subsides.

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