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Bursitis

Definition and Epidemiology

  • Bursitis is the inflammation of a bursa, a small fluid-filled sac that acts as a cushion between bones, tendons, and muscles.
  • Common in adults, especially over 40 years.
  • Often affects shoulder, elbow, hip, knee, and heel.
  • Can be acute or chronic and is frequently associated with repetitive motion or prolonged pressure.

Pathophysiology

  • Inflammation of the bursa often due to repetitive movement or trauma.
  • Can also result from infection (septic bursitis) or systemic inflammatory conditions like rheumatoid arthritis.
  • The inflamed bursa produces excess fluid, leading to pain and restricted movement.

Clinical Features

  • Pain, especially with movement or pressure.
  • Swelling, tenderness, and redness over the affected area.
  • Reduced range of motion in the adjacent joint.
  • In septic bursitis: fever and systemic symptoms may occur.

Diagnosis

  • Primarily clinical based on history and physical examination.
  • Imaging (ultrasound or MRI) can confirm diagnosis and rule out other conditions.
  • Aspiration of bursal fluid for analysis is important in cases of suspected septic bursitis.

Management

  • Non-pharmacological:
    • Rest and avoiding activities that exacerbate symptoms.
    • Ice application to reduce swelling.
    • Physiotherapy to strengthen surrounding muscles.
  • Pharmacological:
    • NSAIDs for pain and inflammation.
    • Corticosteroid injections for severe or persistent cases.
  • Surgical: Rarely needed, but may be considered for recurrent or non-responsive bursitis.

Prognosis

  • Generally good with appropriate management.
  • Most cases resolve within a few weeks, though some may recur or become chronic.

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