The following common symptomatology is seen among patients with acute, chronic and recurrent bursitis:

• Joint pain and limitation of range of motion
• Joint stiffness
• Tenderness during palpation and movement
• Swelling of bursae and joint region
• Erythema over the joint area
• Unexplained bruising of the area of the bursae
• Reddish rash around the affected joint

Most of this signs and symptoms are conservatively treated at home or in a primary health facility. Patients are however advised to seek professional help if they experience the following with bursitis:

• Occurrence of fever
• Disabling joint pains
• Persistent joint pains for more than 1 to 2 weeks
• Excessive swelling and bruising in the affected area
• Sharp pain during exercise and exertion

• Weakness

  There will be pain and weakness in the arm, particularly when it is lifted sideways through a 60-degree arc. Pain may also be felt when you press in at the inside front of the upper arm. [sportsinjuryclinic.net]

  Other possible factors causing bursitis could include gluteus medius weakness. Weakness in this muscle will be conducive to many digressions when walking, running or squatting. [joionline.net]

  The long-term solution is to address the weak gluteal muscles rather than solely focus on the bursitis itself. [physioworks.com.au]

  It has been reported to be related to chronic repetitive mechanical stress of the periscapular tissue, trauma, overuse, and focal muscle weakness. [ncbi.nlm.nih.gov]

• Arm Pain

  Painful arc of movement – shoulder pain felt between 60 - 90° of the arm moving up and outwards. When your arm is by your side there is minimal pain and above 90° relief of pain. [physioworks.com.au]

• Swollen Knee

  Do not put any pressure on the sore area while it is swollen. For example, don’t kneel on a swollen knee. [summitmedicalgroup.com]

• Malaise

  #-varecertifikater, der udstedes i medfør af denne beslutning, skal indeholde en af følgende angivelser en hypesthesia, arthralgia, asthenia, pain, bursitis, dermatitis, headache, injection site hypersensitivity, malaise, nausea, paresthesia, postural [da.glosbe.com]

• Warm Skin

  Some symptoms of infection include: joint pain fever chills warm skin that appears red feeling ill Psoas syndrome is an injury to the psoas muscle. The psoas muscle is one of a group of muscles that join up to form the iliopsoas muscle. [medicalnewstoday.com]

• Hip Pain

  Before a doctor makes a diagnosis of hip bursitis he or she must rule out other common problems that could cause hip pain, including lower back problems such as spinal stenosis or degenerative disc disease, as well as hip osteoarthritis, osteonecrosis [arthritis-health.com]

  Common conditions that can cause lateral hip pain are: Iliotibial Band Syndrome Snapping Hip Syndrome Gluteus Medius Tendon Dysfunction and Tears Meralgia Paresthetica Referred Pain Outcome Measures • VAS-scale for pain • International Hip Outcome Tool [physio-pedia.com]

• Knee Pain

  Calcific bursitis of the MCL of the knee is very uncommon, but should be taken into account in differential diagnoses for medial knee pain. UGPL is proposed as a treatment for this condition. [ncbi.nlm.nih.gov]

  Other causes of knee pain include... [joint-pain-expert.net]

• Frozen Shoulder

  Adhesive Capsulitis, Shoulder Adhesive Frozen Shoulder Frozen Shoulders Shoulder Adhesive Capsulitides Shoulder Adhesive Capsulitis Shoulder, Frozen Shoulders, Frozen Inflammation or irritation of a SYNOVIAL BURSA, the fibrous sac that acts as a cushion [online-medical-dictionary.org]

  Shoulders 349 223 Primary Frozen Shoulder 350 2232 Pathology 351 2235 Clinical Presentation 352 224 Acquired Frozen Shoulder 353 225 Treatment 354 2252 The Acquired Frozen Shoulder 359 226 Rehabilitation 361 228 Summary 362 Arthroscopic Reconstruction [books.google.it]

  Unknown status NCT02039804 Phase 3 Corticosteroids 16 Outcome in Shoulder Capsulitis (Frozen Shoulder) Between Corticosteroid and Corticosteroid With Distension Compared to Wait and See Policy, a Randomised Controlled Trial Unknown status NCT01570985 [malacards.org]

• Heel Pain

  Share: Are you experiencing pain by the bottom of the back of your heel? Then you may be suffering from a common heel condition called Retrocalcaneal Bursitis. Retrocalcaneal bursitis is a medical condition that causes heel pain. [injurymap.com]

  Heel Bursitis Heel pain can be caused by a variety of reasons. Pain in the back of the heel may be due to inflammation of the bursa located in the area where the heel bone connects to the Achilles tendon. [onhealth.com]

  How to treat your knee, hip, and heel pain. Click To Tweet [runnersconnect.net]

  Continue reading… Achilles heel pain from Achilles tendinitis and bursitis, treatment and prevention Achilles tendinitis and Achilles bursitis are two types of heel pain that result from inflammation in the Achilles tendon. [belmarrahealth.com]

• Joint Swelling

  Signs and symptoms of bursitis can include: joint pain joint stiffness joint swelling redness around the area of the joint Symptoms can vary depending on which joint is involved, what caused the irritation, and how long the person has had bursitis. [kidshealth.org]

  Symptoms of bursitis are pain, decreased range of motion at the affected joint, swelling, tenderness around the bursa, warmth around the area and decreased function of the affected joint. [oaph.com]

  Symptoms of bursitis may include any of the following: Joint pain and tenderness when you press around the joint Stiffness and aching when you move the affected joint Swelling, warmth or redness over the joint Pain during movement and rest Pain may spread [nlm.nih.gov]

  They can include: A painful swelling around a joint Swelling that may be red or your normal skin color Sometimes pain when moving the joint Sometimes the bursitis fluid gets infected by bacteria. Infection makes the redness and pain much worse. [msdmanuals.com]

• Suggestibility

  He can create hand and wrist splints and suggest assistive devices to help make daily activities easier. [arthritis.org]

  Subsequent examination revealed a thick calcification spreading along the subacromial-subdeltoid bursa space, suggesting acute calcific bursitis complicated by barbotage. Additional barbotage alleviated her pain completely. [ncbi.nlm.nih.gov]

  Pain around bursae suggests the diagnosis, but sometimes analysis of fluid removed from a bursa or imaging tests are needed. Rest, splinting, nonsteroidal anti-inflammatory drugs, and sometimes corticosteroid injections usually relieve symptoms. [merckmanuals.com]

  If bursitis or tendinitis is painful, doctors may suggest an injection of corticosteroids, platelet-rich plasma, or stem cells to relieve swelling and pain and encourage healing. [nyulangone.org]

• Uremia

  While not the most usual cause of this type of bursal swelling, it can be seen in people who have gout, pseudogout, diabetes, rheumatoid arthritis, uremia and other conditions. The second type is called infected bursitis and is more serious. [hopkinsmedicine.org]

  […] blood flow to the surrounding area increases, and the cellular phase, in which leukocytes migrate from the blood to the affected area.[7]:p. 22 Other possible causes include gout, sarcoidosis, CREST syndrome,[6]:p. 359 diabetes mellitus, alcohol abuse, uremia [en.wikipedia.org]

  […] organisms have been implicated in septic bursitis, including mycobacteria (both tuberculous and nontuberculous strains), fungi (Candida), and algae (Prototheca wickerhamii). [22] Factors predisposing to infection include diabetes mellitus, steroid therapy, uremia [emedicine.medscape.com]

  […] have been implicated in septic bursitis, including mycobacteria (both tuberculous and nontuberculous strains), fungi ( Candida ), and algae ( Prototheca wickerhamii ). [22] Factors predisposing to infection include diabetes mellitus, steroid therapy, uremia [emedicine.com]

The following diagnostic procedures and tests are commonly used among patients suffering from bursitis:

Imaging

Although X-ray radiographs cannot detect bursitis, this tool is most useful in ruling out any osseous pathology in the area that could mimic the symptom. Magnetic resonance imaging (MRI) and ultrasonology may be used to ascertain the diagnosis of bursitis when physical examination remains uncertain [7].

Laboratory tests

A fine needle may be inserted at the swollen bursae to harvest the inflamed fluids for laboratory testing. Tests may reveal the state of the inflammation and the type of organism that causes the infection within the bursae.

• Staphylococcus Aureus

  Bursitis is usually caused by Irritation from unusual use or overuse It may also be caused by injury, gout, pseudogout, rheumatoid arthritis, or certain infections, especially those caused by Staphylococcus aureus. [merckmanuals.com]

  For septic bursitis, antibiotics effective against Staphylococcus aureus are generally the initial treatment, with surgery reserved for bursitis not responsive to antibiotics or for recurrent cases. [ncbi.nlm.nih.gov]

  Infected bursae must be drained, and appropriate antibiotics, often against Staphylococcus aureus, are given. Bursitis often recurs if the cause, such as gout, rheumatoid arthritis, or chronic overuse, is not treated or corrected. [msdmanuals.com]

  An infection, especially with Staphylococcus aureus bacteria, can sometimes cause bursitis. [webmd.com]

The majority of cases of bursitis are treated conservatively by affording adequate rest to affected area, application of ice packs, and the use of pain relievers. Where conservative management fails to offer palliative relief and resolution, the following therapies are being implored in cases of bursitis:

• Antibiotics when bursitis is found to be caused by an infective agent.
• Physical therapy to ease the pain and prevent the recurrence of the discomfort.
• Corticosteroid injections may be given directly to the bursae to afford instant relief of the pain among patients [8]. Corticosteroid injections can be guided accurately by the use of ultrasound [9].
• Assistive devices. The use of walkers and walking canes may assist the patient’s mobility and reduce pain symptoms during ambulation.
• Surgery. Inflamed and infected bursae may be surgically drained to relieve the pressure and shorten the clinical course of the disease. Sometimes the whole bursa is surgically removed to permanently address the recurrent problem [10].

There is a very low mortality rating for bursitis. Patients with bursitis are usually treated and followed up on an outpatient basis in most medical facilities. The prognosis of bursitis is generally good for all cases.

The most common cause of bursitis is associated with the repetitive movements and friction that may irritate the bursae. The following common movements and situations may give rise to bursitis:

• Repetitive pitching of a baseball
• Regular lifting of dumbbells overhead
• Extensive kneeling among monks and nuns
• Leaning on the elbows on an extended period of time
• Prolonged sitting on a hard surface 

The less common causes of bursitis include rheumatoid arthritis, gouty arthritis, and infectious arthritis [2].

The world prevalence rate of bursitis in primary care centers is only 4 out of 1000 patient visits. The most common sites of bursitis are the shoulder, elbow, hip, thigh and knee joints. Here is a high incidence of bursitis among athletes especially among the running sports, reaching an incidence ratio of up to 1 of 10 runners. Studies have revealed that men are more prone to bursitis especially those involved in heavy workload labor that involves frequent kneeling [3]. In septic superficial bursitis, men are more predisposed than women with a relative ratio of 17:3.

The advent of the repetitive trauma to the bursae over the joints encourages synovial cytosis. The thickening of the membranes through continuous collagen formation will increase fluid production within the joint. Chronically, this will result in granulation formation on the surface of the synovial which is followed by the onset of fibrosis. The fibrin rich fluid within the bursae can become hemorrhagic is some cases that could trigger an inflammation [4]. Studies relates that these reactions may be mediated by cyclooxygenases, metalloproteases, and cytokines during the inflammatory process.

By convention, there are three kinds of bursitis: Acute, recurrent and chronic forms [5]. Acute bursitis results during the sudden thickening of the synovial fluid causing pain during movement. Chronic bursitis results with long standing pain causing the weakening of the joint muscles, tendons, and ligaments as a complication. The recurrent forms are those sporadic and intermittent attacks of acute bursitis in a period of time like those seen in swimmers, gymnasts, and weight lifters [6].

There are some modifiable factors that can be resorted to prevent the recurrence of bursitis and allay its symptoms. The use of knee pads can greatly reduce the friction of the kneeling surface towards the afflicted bursa. Avoidance of lifting excessive weight loads will prevent the undue pressure on the hips and knee bursae. For those involved in repetitive tasks, frequent breaks may be needed to afford some rest on the bursae and joints involved. Changing one’s position frequently while doing repetitive tasks may also do the trick efficiently. Athletes should do pre-activity warm ups and stretching to strengthen the joints and the muscles around the bursae.

Bursitis is a clinical disease characterized by acute and chronic inflammation of the bursa. This inflammation is usually caused by repetitive trauma or friction, infections, and crystal depositions. Patients usually complain of pain during movement, tenderness, and swelling.

Bursitis is a disorder described as a painful swelling and inflammation of the fluid filled sacs that cushions the bone, muscles and tendons called bursae. These bursae are found in some of the major joints of the body including the shoulder, hip, elbow and the knee joints. Bursitis commonly occurs on joints that do frequent and repetitive movements. In bursitis, the synovial lining histologically thickens and produces excessive fluid that leads to localized swelling and tenderness [1]. Most of the cases are resolved within weeks after resting the affected site or by giving simple pain control measures.

Definition

Bursitis is a medical disorder described as a painful swelling and inflammation of the fluid filled sacs that cushion the bone, muscles and tendons called bursae.

Cause

 Bursitis is caused by any repetitive motion and friction over a bursa. It is caused by trauma, infections. It can also be secondry to crystal depositions.

Symptoms

The common symptoms the patient experiences is pain in the affected area, tenderness, limitation of movement, and swelling.

Diagnosis

The diagnosis of bursitis can be made by proper physical examination most of the times. Imaging studies sometimes can give a better clue. Specific diagnosis of the causative agent can sometimes be made by laboratory examination of bursa aspirate.

Treatment

Treatment involves adequate rest, applying ice packs, analgesics, antibiotics for infection, physical therapy, joint injections with corticosteroids, and surgery.

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