What is Bursitis?

Bursitis is an acute or chronic inflammation of the bursa. A bursa is a sac-like space in connective tissue. It is a closed sac composed of endothelial cells. The inner wall is a synovial membrane with a little synovial fluid. A few are connected to the joint, located between the bone process near the joint and the tendon or muscle, skin. A bursa can exist where friction or pressure is high. Diseases of many joints can cause the disease.

Basic Information

nickname

Traumatic bursitis

English name

bursitis

Visiting department

orthopedics

Common causes

Caused by injury, partly by direct violent injury

Common symptoms

Bursal fluid and pain

Causes of bursitis

Bursitis can be caused by injury, some are direct violent injuries, some are excessive flexion, extension, abduction, external rotation and other actions. After repeated, long-term, continuous friction and compression, the bursal strain causes inflammation, bursal Thickened by wear. In addition, the pathogenic bacteria carried by the infected lesions can cause purulent bursitis, gout combined with olecranon at the elbow joint and anterior palate bursitis at the knee joint. Bursitis may also be associated with tumors.

Clinical manifestations of bursitis

Acute bursitis

Acute bursitis is characterized by pain, localized tenderness, and restricted mobility. In the case of superficial bursal involvement (before the palate and eagle's mouth), the area is often red and swollen, and the chemical or bacterial bursitis has severe pain. The attack can last from several days to several weeks, and it recurs repeatedly.

2. Chronic bursitis

Chronic bursitis develops after multiple episodes of acute bursitis or repeated trauma. Due to the synovial membrane hyperplasia, the wall of the bursa became thicker, and eventually the bursa became adhesive. Pain, swelling, and tenderness can cause muscle atrophy and restricted movement.

3. Acromion bursitis

Acromion bursitis manifests as localized shoulder pain and tenderness. Especially when the abduction is between 50 ° and 130 °.

4. Traumatic bursitis

Traumatic bursitis is more common and chronic. It is often caused by prolonged, repeated friction and compression in the prominent part of the bone structure. It is often sudden on the basis of chronic bursitis. When the damage is large, it may be accompanied by bloody synovial fluid exudation.

5. Infectious bursitis

Infectious bursitis due to the pathogenic bacteria brought about by the infected lesions can cause purulent bursitis and can cause cellulitis of surrounding tissues, and the sinus is often left after rupture.

6. Gouty Bursitis

Gouty bursitis easily occurs in the olecranon and anterior bursa. Chronic inflammatory changes can occur in the bursal wall, and lime-like deposits can be deposited. Patients often have a history of chronic injury and a career history associated with the disease. There are round or elliptical masses near the joints with clear and varying sizes of edges. Acute pain and tenderness are obvious, while chronic ones are milder, and affected limbs may have different degrees of movement disorders. If secondary infection occurs, there may be redness, swelling, heat, and pain.

Bursitis examination

In some cases, mucus or bloody mucus can be drawn during puncture of the bursal.

Bursitis diagnosis

Patients often have a history of chronic injury and a history of occupations related to the disease. Bone processes near the joints have round or elliptical masses with clear edges of varying sizes. The acute patients have pain and obvious tenderness, and the chronic patients are lighter. The affected limb may have various degrees of movement disorders. Superficial bursae can be detected as fluctuating. Deep bursae or difficult to touch fluctuations due to high intravesical pressure. Mucus or bloody mucus can be obtained by puncture, which can help confirm the diagnosis.

Bursitis treatment

1. Non-infectious acute bursitis

Resting or braking the affected area and high-dose non-steroidal anti-inflammatory drugs may be effective with anesthetic sedatives if necessary. After the pain subsides, active exercise should be increased. If it does not work, remove the synovial fluid and inject the glucocorticoid long-acting preparation into the bursa, or mix at least 3 to 5 ml of local anesthetic with triamcinolone, and inject the synovial fluid with 1% local anesthetic (such as lidocaine). bag. The dosage and admixed volume of the adrenal corticosteroid long-acting preparation depends on the size of the bursa. Infection must be excluded in determining the cause. Patients with stubborn inflammation need repeated pumping and injections. For acute cases with poor curative effect, prednisone or other equivalent hormones can be taken orally for 3 days after excluding infection and gout.

2. Chronic bursitis

The treatment for chronic bursitis is the same as for acute bursitis, but splint fixation and rest may not be as effective as for acute bursitis. X-rays of chronic calcified supra-ganglia tendinitis require very few cases to require surgical resection. Disabling adhesive periarthritis requires repeated intra-articular and extra-articular injections of adrenocortical hormones and enhanced physical therapy. Muscle atrophy must be corrected through exercise to restore range and strength. People with infections need to be given appropriate antibiotics, drained or cut.

Bursitis prevention

1. Strengthen labor protection and develop the habit of washing hands with warm water after working. Rest is the number one solution to any joint pain. If the pain is on the elbow or shoulder, it is recommended to swing the arm freely to relieve the pain.

2. Pointed-toe European shoes have a narrow upper. If you wear these shoes for a long time, your feet will be squeezed and rubbed, which may cause women to suffer from bursitis and hallux valgus deformity.

3. It is necessary to prevent anterior sacral bursitis from kneeling workers, thin elderly women from sedentary tuberculous bursitis after sedentary; heel bursitis caused by over-tight shoes.