MANUAL MINORS
Bursitis is the inflammation of a bursa, a small fluid-filled sac that reduces friction between tissues such as bones, muscles, and tendons. Bursae are located around joints, and bursitis commonly affects areas like the shoulder, elbow, hip, knee, and ankle. This inflammation is caused by overuse, trauma, or prolonged pressure, leading to pain, swelling, and limited movement in the affected joint.
Diagnosis
Diagnosis is based on the clinical presentation of localised pain in the affected joint, associated with swelling, tenderness, and warmth in the area. Pain worsens with movement or pressure on the inflamed bursa.
Physical examination reveals tenderness over the inflamed bursa, with limited range of motion. X-rays are typically normal, but ultrasound or magnetic resonance imaging (MRI) can show bursal inflammation and rule out other causes of joint pain.
Differential Diagnosis
Condition | Key Difference |
|---|---|
Tendinitis | Inflammation of a tendon, with more localised pain along the tendon, worsening with movement of the associated muscle. |
Arthritis | Joint pain with stiffness, involving deeper joint inflammation, often without superficial swelling. |
Cellulitis | Infection of subcutaneous tissues with diffuse redness and fever, not directly related to joint or bursal structures. |
Gout | Sharp pain and inflammation due to uric acid crystals in joints, usually affecting the big toe. |
Emergency Management
In the emergency setting, initial management includes resting the affected joint, applying ice to reduce inflammation, and administering analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control.
If bursitis is related to infection (septic bursitis), antibiotics should be administered, and the bursa may need to be drained through aspiration. In cases of traumatic or chronic bursitis, a splint or compressive bandage may be used to limit movement.
Definitive Treatment
Definitive treatment includes physiotherapy to improve range of motion and strengthen muscles around the affected joint. In chronic bursitis cases, corticosteroid injections can be helpful in reducing inflammation.
It is important to avoid activities that caused the injury, such as overuse or constant pressure on the joint. In refractory cases, where conservative treatment fails, surgery to remove the inflamed bursa may be considered. Most patients recover with conservative management in a few weeks.
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