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==Overview==
==History and Symptoms==
The [[symptoms]] of bursitis vary based on the location of the [[inflammation]]. Focal swelling, [[pain]], and [[redness]] are symptoms common to all forms of bursitis. Limbing, upper or lower extremity weakness, and [[fever]] are possible depending on the type of bursitis. Obtaining a complete history is helpful in determining whether the bursitis is associated with any specific hobbies or work-related activities.<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>
Bursitis most typically occurs in the [[elbow]], [[shoulder]], or [[hip]], although it can also occur in the [[heel]], the [[knee]], or the base of the big [[toe]].
 
==History and symptoms==
It is critical to collect a detailed and thorough history from the patient. Obtaining a complete history will be helpful in determining whether the bursitis is associated with any specific activities.
 
===History===
Specific areas to focus on when obtaining a history from the patient include:<ref name=Harrison-rheumatology>Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.</ref>
*History of repetitive movement
*History of inflammatory disease (such as [[rheumatoid arthritis|rheumatoid arthritis (RF)]], [[systemic lupus erythematosus|systemic lupus erythematosus (SLE)]])
*History of [[trauma]] or microtrauma
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Type of Bursitis}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|History}}
|-
| 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;" |
*History of shoulder injury, [[tendinitis]], or [[impingement syndrome|shoulder impingement syndrome]]
*History of muscle overuse or repetitive activity such as painting, throwing a ball, or playing tennis
|-
| 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;" |
*History of direct trauma to the posterior elbow
*History of microtrauma, such as constantly rubbing the elbow against a table while writing
*History of certain occupations, such as plumbers and technicians
*History of systemic inflammatory processes such as [[rheumatoid arthritis]]
*History of crystal deposition disease, including [[gout]] and [[pseudogout]]
|-
| 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;" |
*History of [[trauma]] such as injury of the [[greater trochanter]]
*History of muscle overuse around the bursa or the joint underneath the bursa
*History of hip [[osteoarthritis]]
*History of inflammatory diseases
*Hip [[prosthesis]]
|-
| 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>
| style="padding: 5px 5px; background: #F5F5F5;" |
*History of sudden knee injury
*Hidtory of microtrauma
*History of [[staphylococcal|staphylococcal infection]]
*History of inflammatory disease such as [[arthritis]]
*History of crystal arthropathy such as [[gout]]
|-
| 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;" |
*History of tight-fitting shoes
*History of [[gout]], [[rheumatoid arthritis]], and [[seronegative spondyloarthropathies]]
*History of Haglund disease
|}
 
===Symptoms===
The symptoms of bursitis differ based on the anatomic location. Localized pain with movement and decreased [[range of motion]] (ROM) are symptoms common to all forms of bursitis.
Localized [[redness]] or [[warmth]] are variable and seen in superficial bursitis.
Septic bursitis is associated with [[fever]], in addition to other symptoms.
 
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Type of Bursitis}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Symptoms}}
|-
| 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;" |
*Mid-shoulder pain early in the course of bursitis, which gradually increases over time; eventually pain may be felt even at rest
*Pain after repetitive activity such as painting, throwing a ball, or playing tennis
*Pain worsens at night
*Popping sensation with shoulder movements
|-
| 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;" |
*Painful or painless focal swelling at the posterior elbow
|-
| 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;" |
*Pain in the lateral side of the hip with walking, running, or stair-climbing
*Weakness of the lower extremities
*Pain with active and passive motion
|-
| 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>
| style="padding: 5px 5px; background: #F5F5F5;" |
*Reduced [[range of motion]] at the knee
*Focal swelling, [[pain]], and [[redness]]
*Difficulty kneeling and walking
|-
| 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;" |
*Swelling at the back of heel
*Pain at the back of the heel, especially when running uphill
*Pain while standing on tiptoes
|}


Symptoms can vary from an ache and stiffness in the local area of the joint, to a burning that surrounds the whole joint around the inflamed bursa. With this condition, the pain is usually worse during and after activity, and the bursa and surrounding joint area can become stiffer the following day.
==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 
 
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Latest revision as of 20:46, 29 July 2020

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

Overview

The symptoms of bursitis vary based on the location of the inflammation. Focal swelling, pain, and redness are symptoms common to all forms of bursitis. Limbing, upper or lower extremity weakness, and fever are possible depending on the type of bursitis. Obtaining a complete history is helpful in determining whether the bursitis is associated with any specific hobbies or work-related activities.[1][2][3]

History and symptoms

It is critical to collect a detailed and thorough history from the patient. Obtaining a complete history will be helpful in determining whether the bursitis is associated with any specific activities.

History

Specific areas to focus on when obtaining a history from the patient include:[1]

Type of Bursitis History
Subacromial bursitis[2]
Olecranon bursitis[4][5]
  • History of direct trauma to the posterior elbow
  • History of microtrauma, such as constantly rubbing the elbow against a table while writing
  • History of certain occupations, such as plumbers and technicians
  • History of systemic inflammatory processes such as rheumatoid arthritis
  • History of crystal deposition disease, including gout and pseudogout
Trochanteric bursitis[6][7]
Prepatellar bursitis[3][8]
Retrocalcaneal bursitis[1][9]

Symptoms

The symptoms of bursitis differ based on the anatomic location. Localized pain with movement and decreased range of motion (ROM) are symptoms common to all forms of bursitis. Localized redness or warmth are variable and seen in superficial bursitis. Septic bursitis is associated with fever, in addition to other symptoms.


Type of Bursitis Symptoms
Subacromial bursitis[2]
  • Mid-shoulder pain early in the course of bursitis, which gradually increases over time; eventually pain may be felt even at rest
  • Pain after repetitive activity such as painting, throwing a ball, or playing tennis
  • Pain worsens at night
  • Popping sensation with shoulder movements
Olecranon bursitis[4][5]
  • Painful or painless focal swelling at the posterior elbow
Trochanteric bursitis[6][7]
  • Pain in the lateral side of the hip with walking, running, or stair-climbing
  • Weakness of the lower extremities
  • Pain with active and passive motion
Prepatellar bursitis[3][8]
Retrocalcaneal bursitis[1][9]
  • Swelling at the back of heel
  • Pain at the back of the heel, especially when running uphill
  • Pain while standing on tiptoes

References

  1. ↑ 1.0 1.1 1.2 1.3 Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.
  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.
  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.
  4. ↑ 4.0 4.1 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.
  5. ↑ 5.0 5.1 Lockman L (2010). "Treating nonseptic olecranon bursitis: a 3-step technique". Can Fam Physician. 56 (11): 1157. PMC 2980436. PMID 21075998.
  6. ↑ 6.0 6.1 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.
  7. ↑ 7.0 7.1 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.
  8. ↑ 8.0 8.1 Huang, Yu-Chih, and Wen-Lin Yeh. "Endoscopic treatment of prepatellar bursitis." International orthopaedics 35.3 (2011): 355-358.
  9. ↑ 9.0 9.1 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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