Doctor's Notes on Bursitis
Bursitis is inflammation of a bursa, a small sac that function to reduce friction between bone and soft tissue – there are 160 bursae in the body was the largest mainly near the hip, knee, shoulder and elbow tendons. Signs and symptoms of bursitis are directly related to the degree of inflammation in the bursa and in its location in the body (for example, the shoulder, hip, knee, elbow). Signs and symptoms vary from local joint swelling and stiffness to painful joint motion, sometimes so painful that makes it difficult for the patient to put even mild stress on the joint. The joint area may exhibit redness and feel warm to touch.Causes of bursitis include injury, joint overuse, rheumatic conditions, inflammation due to crystals (gout) and occasionally, infections.
The symptoms of bursitis are directly related to the degree of inflammation present in the bursa and the location of the bursa involved. The inflamed bursa can cause localized pain and tenderness. If the bursa is so inflamed that swelling occurs, it can cause local swelling and stiffness, sometimes associated with local redness and warmth. The inflammation can make it painful to support body pressure. For example, hip bursitis can make it difficult to lie on the affected side of the hip. As another example, bursitis of the inner knee (anserine bursitis) can make it painful to lie with the knees touching each other.
Because there are 160 bursae in the body, there are many different areas of the body that can be affected by bursitis. The symptoms may affect the side of the hip (trochanteric bursitis), shoulder (subacromial or sub deltoid bursitis), the elbow (olecranon bursitis), the knee (pes anserine bursitis on the inner aspect of the knee, prepatellar bursitis on top of the kneecap), the ischial tuberosity in the buttock (ischial bursitis), or the foot and heel (calcaneal bursitis, intermetatarsal bursitis).
A bursa can become inflamed from injury, infection (rare in the shoulder), or due to an underlying rheumatic condition. Examples of bursitis include injury as subtle as lifting a bag of groceries into the car to inflame the shoulder bursa (shoulder bursitis), infection of the bursa in front of the knee from an abrasion or puncture wound (septic prepatellar bursitis), and inflammation of the elbow bursa from gout crystals (gouty olecranon bursitis). Sometimes tendonitis occurs associated with bursitis, especially in the shoulder.
Bursitis is inflammation of the bursae, the fluid-filled sacs that protect against friction between bones and other tissues. Depending on the location in the body, bursae may cushion bones from other bones, tendons, muscle, or skin. Bursitis can occur in many areas of the body. It is most common in the elbows and wrists. The ankles, hips, or knees may also be affected. Bursitis is caused by overuse injury or other trauma. Repetitive movements increase the risk of bursitis. Certain conditions like thyroid disease, diabetes, arthritis, and infections can inflame the bursa.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.