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.