Bursitis Flashcards
What is bursitis?
Inflammation of a bursa
Describe the pathophysiology of bursitis
When the bursa is inflamed, fluid production + capillary permeability increase
Fluid + proteinaceous exudates collect in the bursa, causing swelling.
What is a bursa?
Sac containing a small amount of synovial fluid that lies between a tendon + either skin/ bone to act as a friction buffer.
Which soft tissues are commonly affected by bursitis?
Shoulder
Elbow
Hip
Buttocks
Knees
Calf
Which groups are more likely to get bursitis?
Athletes
Elderly
People who do repetitive movements like manual laborers + musicians
Give 3 nicknames for bursitis
Olecranon bursitis (‘student’s elbow’)
Prepatellar bursitis (‘housemaid’s knee’)
Infrapatellar bursitis (‘clergyman’s knee’)
Which conditions are associated with bursitis?
AI disease: RhA
Crystal arthropathies (Gout + Pseudogout)
What is the main presenting symptom of bursitis?
Pain at site of bursa
List 3 signs of bursitis
Tenderness to palpation
Decreased active ROM
Swelling
List 3 additional signs of septic bursitis
Low grade temperature
Erythema
Warmth of overlying skin
How is bursitis diagnosed?
Clinical dx
What investigations may be used in bursitis? Why?
Gram stain + culture of fluid aspirate: ?septic bursitis
Crystal analysis: ?gout/ pseudogout
X-Ray: ?bone tumour
MRI: ?associated pathology e.g. rotator cuff tear
Describe the first-line management of non- septic bursitis
Avoid exacerbating activities + rest affected area
Gentle mobilisation +/- walking stick/ crutch
Ice
Analgesia: Paracetemol +/- topical NSAIDs
What is second and third line management of non- septic bursitis?
2nd: Steroid injection
3rd: Surgery
Describe the first-line management of septic bursitis
Abx: Cefazolin IV
+
Aspiration of bursa
+
Activity modification
+
Analgesia: Paracetamol
