Bursae Disorders Flashcards
What are bursae?
aclike structures between skin and bone or between tendons, ligaments, and bone.
What is the presentation of bursitis?
- Localized tenderness
- Decreased range of motion or pain with movement
- Erythema or edema (seen in superficial bursitis)
- History of repetitive movement (eg, frequent kneeling leading to prepatellar or infrapatellar bursitis)
- enderness at the site of the inflamed bursa
- warmth, edema, and erythema of the skin (possible indicative of septic bursitis)
What are the causes of bursitis?
- autoimmune disorders
- crystal deposition (gout and pseudogout)
- infectious diseases (Staphylococcus aureus are 80% of cases, followed by streptococci).
- traumatic events -hemorrhagic disorders -secondary to overuse.
What is the pathophysiology of bursitis?
Bursitis occurs when the synovial lining becomes thickened and produces excessive fluid, leading to localized swelling and pain. Inflammation of the bursa causes synovial cells to multiply and thereby increases collagen formation and fluid production. A more permeable capillary membrane allows entrance of high protein fluid. The bursal lining may be replaced by granulation tissue followed by fibrous tissue.
What is the pathophysiology in septic arthritis?
local trauma usually causes inoculation of bacteria into the bursa, which triggers the inflammatory process
What are the 3 phases of bursitis?
- acute
- recurrent
- chronic
What investigations are used for bursitis?
- bloods (ESR, ANA, RF, anti-CCP)
- aspiration
- US if still unsure
What are DDx of bursitis?
- tendinitis
- Septic arthritis
- Ligamentous injury -Fracture
- Osteoarthritis
What is the management of bursitis?
Conservative treatment includes rest, cold and heat treatments, elevation, administration of nonsteroidal anti-inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections.
If septic bursitis antibiotics should also be used.
