musculoskeletal and connective tissue disorders
Bursitis
Introduction
Bursitis is acute or chronic inflammation of a bursa. The cause is usually unknown, but trauma, repetitive or acute, may contribute, as may infection and crystal-induced disease. Symptoms include pain (particularly with motion or pressure), swelling, and tenderness. Diagnosis is usually clinical; however, ultrasonography may be needed to evaluate deep bursae. Diagnosis of infection and crystal-induced disease requires analysis of bursal fluid. Treatment includes splinting, nonsteroidal anti-inflammatory drugs (NSAIDs), sometimes corticosteroid injections, and treatment of the underlying cause. Bursae are fluid-filled sac-like cavities or potential cavities that are located where friction occurs (eg, where tendons or muscles pass over bony prominences). Bursae minimize friction between moving parts and facilitate movement. Some communicate with joints. Bursitis may occur in the shoulder (subacromial or subdeltoid bursitis), particularly in patients with Rotator Cuff Injury/Subacromial Bursitis , which is usually the primary lesion in the shoulder. Other commonly affected bursae include olecranon (miner's or barfly’s elbow), prepatellar (housemaid’s knee), suprapatellar, retrocalcaneal, iliopectineal (iliopsoas), ischial (weaver’s bottom), greater trochanteric, pes anserine, and first metatarsal head (bunion) bursae. Occasionally, a bursa ruptures or develops a chronic communication with an adjacent joint. 