Bursitis differential diagnosis: Difference between revisions

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Latest revision as of 20:46, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Bursitis symptoms and signs are relatively non-specific. Even after collecting a detailed history and performing a physical examination, imaging studies are often necessary to rule out other musculoskeletal conditions. Bursitis must be differentiated from tendonitis, cellulitis, osteoarthritis, ligamentous injuries, and septic arthritis.^[1]^[2]^[3]

Differentiating Bursitis from other Diseases

Bursitis must be differentiated from:^[1]^[2]^[3]

Anatomic location

Based on anatomic location, bursitis must be differentiated from:


Type of Bursitis	Differential diagnosis
Subacromial bursitis^[2]	Rotator cuff tendinitis Supraspinatus tendinitis Bicipital tendinitis Frozen shoulder or adhesive capsulitis Rotator cuff tears
Olecranon bursitis^[4]^[5]	Triceps tendinitis Olecranon spur Gout and Pseudogout Fracture of the olecranon process of the ulna Synovial cyst of the elbow joint Lipoma
Trochanteric bursitis^[6]^[7]	Femur Injuries and fractures Femoral neck stress fracture Femoral head avascular necrosis Lumbar disk Problems Sacroiliac Joint Injury Hamstring Injury Iliopsoas tendinitis Lumbar and lumbosacral disk injuries Lumbosacral radiculopathy Lumbosacral spine strain or sprain Spondylolisthesis
Prepatellar bursitis^[3]^[8]^[9]	Meniscal tear Spontaneous osteonecrosis Tumors Proximal tibia stress fracture Medial collateral ligament and Lateral collateral Ligament Injury Posterior cruciate ligament injury Osteoarthritis Rheumatoid Arthritis (RF) Pes Anserine Bursitis Baker's cyst
Retrocalcaneal bursitis^[1]^[10]	Achilles tendonitis Posterior ankle impingment Haglund deformity Tendon rupture Plantar fasciitis

References

↑ ^1.0 ^1.1 ^1.2 Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.
↑ ^2.0 ^2.1 ^2.2 Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.
↑ ^3.0 ^3.1 ^3.2 Aaron, Daniel L., et al. "Four common types of bursitis: diagnosis and management." Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.
↑ Stell IM (1996). "Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management". J Accid Emerg Med. 13 (5): 351–3. PMC 1342774. PMID 8894865.
↑ Lockman L (2010). "Treating nonseptic olecranon bursitis: a 3-step technique". Can Fam Physician. 56 (11): 1157. PMC 2980436. PMID 21075998.
↑ Brinks A, van Rijn RM, Bohnen AM, Slee GL, Verhaar JA, Koes BW; et al. (2007). "Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice". BMC Musculoskelet Disord. 8: 95. doi:10.1186/1471-2474-8-95. PMC 2045096. PMID 17880718.
↑ Karpinski MR, Piggott H (1985). "Greater trochanteric pain syndrome. A report of 15 cases". J Bone Joint Surg Br. 67 (5): 762–3. PMID 4055877.
↑ Huang, Yu-Chih, and Wen-Lin Yeh. "Endoscopic treatment of prepatellar bursitis." International orthopaedics 35.3 (2011): 355-358.
↑ Meyerding, Henry W., and ROBERT E. VanDEMARK. "POSTERIOR HERNIA OF THE KNEE:(BAKER'S CYST, POPLITEAL CYST, SEMIMEMBRANOSUS BURSITIS, MEDIAL GASTROCNEMIUS BURSITIS AND POPLITEAL BURSITIS)." Journal of the American Medical Association 122.13 (1943): 858-861.
↑ Lyman, Jeffrey, Paul S. Weinhold, and Louis C. Almekinders. "Strain behavior of the distal Achilles tendon implications for insertional Achilles tendinopathy." The American Journal of Sports Medicine 32.2 (2004): 457-461.

Template:WH Template:WS

[Harrison-rheumatology-1] 1.0 ^1.1 ^1.2 Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.

[bursitis-upper-limb-2] 2.0 ^2.1 ^2.2 Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.

[Bursitis-four-types-3] 3.0 ^3.1 ^3.2 Aaron, Daniel L., et al. "Four common types of bursitis: diagnosis and management." Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.

[pmid8894865-4] Stell IM (1996). "Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management". J Accid Emerg Med. 13 (5): 351–3. PMC 1342774. PMID 8894865.

[pmid21075998-5] Lockman L (2010). "Treating nonseptic olecranon bursitis: a 3-step technique". Can Fam Physician. 56 (11): 1157. PMC 2980436. PMID 21075998.

[pmid17880718-6] Brinks A, van Rijn RM, Bohnen AM, Slee GL, Verhaar JA, Koes BW; et al. (2007). "Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice". BMC Musculoskelet Disord. 8: 95. doi:10.1186/1471-2474-8-95. PMC 2045096. PMID 17880718.

[pmid4055877-7] Karpinski MR, Piggott H (1985). "Greater trochanteric pain syndrome. A report of 15 cases". J Bone Joint Surg Br. 67 (5): 762–3. PMID 4055877.

[Prepatellar-Bursitis-8] Huang, Yu-Chih, and Wen-Lin Yeh. "Endoscopic treatment of prepatellar bursitis." International orthopaedics 35.3 (2011): 355-358.

[9] Meyerding, Henry W., and ROBERT E. VanDEMARK. "POSTERIOR HERNIA OF THE KNEE:(BAKER'S CYST, POPLITEAL CYST, SEMIMEMBRANOSUS BURSITIS, MEDIAL GASTROCNEMIUS BURSITIS AND POPLITEAL BURSITIS)." Journal of the American Medical Association 122.13 (1943): 858-861.

[Achilles-tendon-10] Lyman, Jeffrey, Paul S. Weinhold, and Louis C. Almekinders. "Strain behavior of the distal Achilles tendon implications for insertional Achilles tendinopathy." The American Journal of Sports Medicine 32.2 (2004): 457-461.

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@@ Line 4: / Line 4: @@
 ==Overview==
+Bursitis symptoms and signs are relatively non-specific. Even after collecting a detailed history and performing a physical examination, imaging studies are often necessary to rule out other musculoskeletal conditions. Bursitis must be differentiated from [[tendonitis]], [[cellulitis]], [[osteoarthritis]], [[ligament|ligamentous injuries]], and [[septic arthritis]].<ref name=Harrison-rheumatology> Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.</ref><ref name=bursitis-upper-limb> Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.</ref><ref name=Bursitis-four-types> Aaron, Daniel L., et al. "Four common types of bursitis: diagnosis and management." Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.</ref>
-==Differentiating Conjunctivitis from other Diseases==
+==Differentiating Bursitis from other Diseases==
-Bursitis must be differentiated from:
+Bursitis must be differentiated from:<ref name=Harrison-rheumatology> Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.</ref><ref name=bursitis-upper-limb> Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.</ref><ref name=Bursitis-four-types> Aaron, Daniel L., et al. "Four common types of bursitis: diagnosis and management." Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.</ref>
-*Septic arthritis
+*[[Tendonitis]]
+*[[Cellulitis]]
+*[[Osteoarthritis]]
+*[[Gout]] and [[Pseudogout]]
+*[[Rheumatoid Arthritis|Rheumatoid Arthritis (RA)]]
+*[[Septic arthritis]]
 *Ligamentous injury
-*Fracture
+*[[Fracture]]
-*Osteoarthritis
 ===Anatomic location===
-Knee bursitis must be differentiated from:
+Based on anatomic location, bursitis must be differentiated from:
+{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
+|+
+! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Type of Bursitis}}
+! style="background: #4479BA; width: 650px;" | {{fontcolor|#FFF|Differential diagnosis}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Subacromial bursitis]]'''<ref name=bursitis-upper-limb> Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.</ref>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*[[tendinitis|Rotator cuff tendinitis]]
+*[[tendinitis|Supraspinatus tendinitis]]
+*[[tendinitis|Bicipital tendinitis]]
+*[[Frozen shoulder]] or [[adhesive capsulitis]]
+*[[Rotator cuff|Rotator cuff tears]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Olecranon bursitis]]'''<ref name="pmid8894865">{{cite journal| author=Stell IM| title=Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management. | journal=J Accid Emerg Med | year= 1996 | volume= 13 | issue= 5 | pages= 351-3 | pmid=8894865 | doi= | pmc=1342774 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8894865  }} </ref><ref name="pmid21075998">{{cite journal| author=Lockman L| title=Treating nonseptic olecranon bursitis: a 3-step technique. | journal=Can Fam Physician | year= 2010 | volume= 56 | issue= 11 | pages= 1157 | pmid=21075998 | doi= | pmc=2980436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21075998  }} </ref>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*[[Triceps]] [[tendinitis]]
+*[[Olecranon]] spur
+*[[Gout]] and [[Pseudogout]]
+*[[Fracture]] of the [[ulna|olecranon process of the ulna]]
+*Synovial cyst of the elbow joint
+*[[Lipoma]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Trochanteric bursitis]]'''<ref name="pmid17880718">{{cite journal| author=Brinks A, van Rijn RM, Bohnen AM, Slee GL, Verhaar JA, Koes BW et al.| title=Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice. | journal=BMC Musculoskelet Disord | year= 2007 | volume= 8 | issue=  | pages= 95 | pmid=17880718 | doi=10.1186/1471-2474-8-95 | pmc=2045096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17880718  }} </ref><ref name="pmid4055877">{{cite journal| author=Karpinski MR, Piggott H| title=Greater trochanteric pain syndrome. A report of 15 cases. | journal=J Bone Joint Surg Br | year= 1985 | volume= 67 | issue= 5 | pages= 762-3 | pmid=4055877 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4055877  }} </ref>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Femur Injuries and [[fractures]]
+*Femoral neck [[stress fracture]]
+*Femoral head [[avascular necrosis]]
+*[[Lumbar disk|Lumbar disk Problems]]
+*[[Sacroiliac Joint]] Injury
+*[[Hamstring|Hamstring Injury]]
+*[[Iliopsoas]] [[tendinitis]]
+*Lumbar and lumbosacral disk injuries
+*Lumbosacral [[radiculopathy]]
+*Lumbosacral spine strain or sprain
+*[[Spondylolisthesis]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Prepatellar bursitis]]'''<ref name=Bursitis-four-types> Aaron, Daniel L., et al. "Four common types of bursitis: diagnosis and management." Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.</ref><ref name=Prepatellar-Bursitis> Huang, Yu-Chih, and Wen-Lin Yeh. "Endoscopic treatment of prepatellar bursitis." International orthopaedics 35.3 (2011): 355-358.</ref><ref>Meyerding, Henry W., and ROBERT E. VanDEMARK. "POSTERIOR HERNIA OF THE KNEE:(BAKER'S CYST, POPLITEAL CYST, SEMIMEMBRANOSUS BURSITIS, MEDIAL GASTROCNEMIUS BURSITIS AND POPLITEAL BURSITIS)." Journal of the American Medical Association 122.13 (1943): 858-861.</ref>
+| style="padding: 5px 5px; background: #F5F5F5;" |
 *[[Meniscal tear]]
 *[[osteonecrosis|Spontaneous osteonecrosis]]
-*Tumors
+*[[Tumor]]s
-*Other bursitis of the knee
 *Proximal tibia [[stress fracture]]
-*[[Medial Collateral|Medial Collateral Ligament]] and [[Lateral Collateral Ligament|Lateral Collateral Ligament]] Injury
+*[[Medial collateral ligament]] and [[Lateral collateral ligament|Lateral collateral Ligament Injury]]
-*Osteoarthritis
+*[[Posterior cruciate ligament|Posterior cruciate ligament injury]]
+*[[Osteoarthritis]]
 *[[Rheumatoid Arthritis|Rheumatoid Arthritis (RF)]]
+*Pes Anserine Bursitis
+*[[Baker's cyst]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Retrocalcaneal bursitis]]'''<ref name=Harrison-rheumatology> Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.</ref><ref name=Achilles-tendon> Lyman, Jeffrey, Paul S. Weinhold, and Louis C. Almekinders. "Strain behavior of the distal Achilles tendon implications for insertional Achilles tendinopathy." The American Journal of Sports Medicine 32.2 (2004): 457-461.</ref>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*[[tendonitis|Achilles tendonitis]]
+*Posterior ankle impingment
+*[[Haglund deformity]]
+*Tendon rupture
+*[[Plantar fasciitis]]
+|}
 ==References==
@@ Line 26: / Line 80: @@
+{{WH}}
+{{WS}}
+[[Category:Disease]]
+[[Category:Up-To-Date]]
+[[Category:Rheumatology]]
 [[Category:Orthopedics]]
-[[Category:Rheumatology]]
+[[Category:Surgery]]
-[[Category:Primary care]]
+[[Category:Emergency medicine]]
 [[Category:Infectious disease]]
-{{WH}}
-{{WS}}