Bursitis medical therapy: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 3: | Line 3: | ||
{{CMG}}; {{AE}} {{SaraM}} | {{CMG}}; {{AE}} {{SaraM}} | ||
==Overview== | ==Overview== | ||
Medical therapy for non-septic bursitis depends on the involved [[bursa]] and includes the RICE regimen (rest, ice, compression, elevation), NSAIDs, and/or [[corticosteroid]] injections. Restriction of activity is encouraged to prevent further injury and promote healing. Antimicrobials are the mainstay of therapy for septic bursitis. Surgical management is often reserved for non-responders.<ref name="pmid26577126">{{cite journal| author=Reilly D, Kamineni S| title=Olecranon bursitis. | journal=J Shoulder Elbow Surg | year= 2016 | volume= 25 | issue= 1 | pages= 158-67 | pmid=26577126 | doi=10.1016/j.jse.2015.08.032 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26577126 }} </ref><ref name="pmid7667644">{{cite journal| author=Zimmermann B, Mikolich DJ, Ho G| title=Septic bursitis. | journal=Semin Arthritis Rheum | year= 1995 | volume= 24 | issue= 6 | pages= 391-410 | pmid=7667644 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7667644 }} </ref><ref name="pmid21628647">{{cite journal| author=Aaron DL, Patel A, Kayiaros S, Calfee R| title=Four common types of bursitis: diagnosis and management. | journal=J Am Acad Orthop Surg | year= 2011 | volume= 19 | issue= 6 | pages= 359-67 | pmid=21628647 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21628647 }} </ref> | Medical therapy for non-septic bursitis depends on the involved [[bursa]] and includes the [[RICE]] regimen (rest, ice, compression, elevation), [[NSAIDs]], and/or [[corticosteroid]] injections. Restriction of activity is encouraged to prevent further injury and promote healing. [[Antimicrobials]] are the mainstay of therapy for septic bursitis. Surgical management is often reserved for non-responders.<ref name="pmid26577126">{{cite journal| author=Reilly D, Kamineni S| title=Olecranon bursitis. | journal=J Shoulder Elbow Surg | year= 2016 | volume= 25 | issue= 1 | pages= 158-67 | pmid=26577126 | doi=10.1016/j.jse.2015.08.032 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26577126 }} </ref><ref name="pmid7667644">{{cite journal| author=Zimmermann B, Mikolich DJ, Ho G| title=Septic bursitis. | journal=Semin Arthritis Rheum | year= 1995 | volume= 24 | issue= 6 | pages= 391-410 | pmid=7667644 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7667644 }} </ref><ref name="pmid21628647">{{cite journal| author=Aaron DL, Patel A, Kayiaros S, Calfee R| title=Four common types of bursitis: diagnosis and management. | journal=J Am Acad Orthop Surg | year= 2011 | volume= 19 | issue= 6 | pages= 359-67 | pmid=21628647 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21628647 }} </ref> | ||
==Medical Therapy== | ==Medical Therapy== | ||
Revision as of 19:11, 19 September 2016
|
Bursitis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Bursitis medical therapy On the Web |
|
American Roentgen Ray Society Images of Bursitis medical therapy |
|
Risk calculators and risk factors for Bursitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Medical therapy for non-septic bursitis depends on the involved bursa and includes the RICE regimen (rest, ice, compression, elevation), NSAIDs, and/or corticosteroid injections. Restriction of activity is encouraged to prevent further injury and promote healing. Antimicrobials are the mainstay of therapy for septic bursitis. Surgical management is often reserved for non-responders.[1][2][3]
Medical Therapy
| Septic[1][2] | Aseptic |
|---|---|
|
|
Subacromial Bursitis
Conservative measures which are recommended among all patients who developed subacromial bursitis include:[4][5]
- Physical therapy (PT)
- Scapular strengthening and postural reeducation
- Shoulder exercise
- Corticosteroid injection
- Nonsteroidal anti-inflammatory medications (NSAIDs)
Physical therapy and NSAIDs are the most effective therapies for trochanteric bursitis
Prepatellar Bursitis
Conservative measures which are recommended among all patients who developed prepatellar bursitis include: [3][6]
- Nonsteroidal anti-inflammatory medications (NSAIDs) is often use as a first chose
- Decrease physical activities
- RICE regimen in the first 72 hours after the injury (rest, ice, compression, elevation)
- Physical therapy (PT)
- Local corticosteroid injections may be used in some patients who do not respond to initial therapy
Olecranon Bursitis
Conservative measures which are recommended among all patients who developed olecranon bursitis include:[3][7]
- RICE regimen in the first 72 hours after the injury (rest, ice, compression, elevation)
- Avoidance of aggravating activity
- Most patients improve significantly with these measures and most of the time physical and occupational therapy are not necessary
- Early aspiration (with or without corticosteroid injection) may be helpful among patients with bothersome fluid collections
- Diagnostic aspiration should be performed among patients who do not respond to rule out possible infection
Trochanteric Bursitis
Conservative measures which are recommended among all patients who developed trochanteric bursitis include:[3][8]
- Activity modification
- Weight loss
- Physical therapy (PT)
- Nonsteroidal anti-inflammatory medications (NSAIDs)
- Local glucocorticoid injections are reserved for patients with refractory symptoms
Physical therapy and NSAIDs are the most effective therapies for trochanteric bursitis. Most patients do not require any surgical intervention
Retrocalcaneal Bursitis
Conservative measures which are recommended among all patients who developed retrocalcaneal bursitis include:[3][9]
- RICE regimen in the first 72 hours after the injury (rest, ice, compression, elevation)
- Maneuvers that stretch the Achilles tendon may be helpful
- Limitation of activity and modification of footwear to avoid posterior heel irritation
- Nonsteroidal anti-inflammatory medications (NSAIDs) and orthoses
- Physical therapy (PT)
- Corticosteroid injections are not recommended as they may have adverse effects on the Achilles tendon.
Antimicrobial Regimens
- Septic bursitis [10]
- 1. Staphylococcus aureus, methicillin-susceptible (MSSA)
- Preferred regimen (1): Nafcillin 2 g IV q4h
- Preferred regimen (2): Oxacillin 2 g IV q4h
- Preferred regimen (3): Dicloxacillin 500 mg PO qid
- 2. Staphylococcus aureus, methicillin-resistant (MRSA)
- Preferred regimen (1): Vancomycin 1 g IV q12h
- Preferred regimen (2): Linezolid 600 mg PO qd
References
- ↑ 1.0 1.1 Reilly D, Kamineni S (2016). "Olecranon bursitis". J Shoulder Elbow Surg. 25 (1): 158–67. doi:10.1016/j.jse.2015.08.032. PMID 26577126.
- ↑ 2.0 2.1 Zimmermann B, Mikolich DJ, Ho G (1995). "Septic bursitis". Semin Arthritis Rheum. 24 (6): 391–410. PMID 7667644.
- ↑ 3.0 3.1 3.2 3.3 3.4 Aaron DL, Patel A, Kayiaros S, Calfee R (2011). "Four common types of bursitis: diagnosis and management". J Am Acad Orthop Surg. 19 (6): 359–67. PMID 21628647.
- ↑ Van der Windt, D. A., et al. "Shoulder disorders in general practice: incidence, patient characteristics, and management." Annals of the rheumatic diseases 54.12 (1995): 959-964.
- ↑ Chang, Won Hyuk, et al. "Comparison of the therapeutic effects of intramuscular subscapularis and scapulothoracic bursa injections in patients with scapular pain: a randomized controlled trial." Rheumatology international 34.9 (2014): 1203-1209.
- ↑ Wilson-MacDonald J (1987). "Management and outcome of infective prepatellar bursitis". Postgrad Med J. 63 (744): 851–3. PMC 2428634. PMID 3447109.
- ↑ Lockman, Leonard. "Treating nonseptic olecranon bursitis A 3-step technique." Canadian Family Physician 56.11 (2010): 1157-1157.
- ↑ Farmer, Kevin W., et al. "Trochanteric bursitis after total hip arthroplasty: incidence and evaluation of response to treatment." The Journal of arthroplasty 25.2 (2010): 208-212.
- ↑ Vallone G, Vittorio T (2014). "Complete Achilles tendon rupture after local infiltration of corticosteroids in the treatment of deep retrocalcaneal bursitis". J Ultrasound. 17 (2): 165–7. doi:10.1007/s40477-014-0066-9. PMC 4033727. PMID 24883139.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.