Bursitis is the condition that occurs when a bursa becomes inflamed or infected.
A bursa is a sac with a potential space that makes it easier for one tissue to glide over another.
There are approximately 160 bursae in the body but only a few of them become clinically affected.
Most bursae differentiate during development, but new ones may form in response to stress, inflammation, or trauma.
Occasionally, a bursa may communicate with a nearby joint.
Clinical aspects of subacromial bursitis:
- Primary inflammation of the bursa may occur as a result of crystal deposition or infection
- Clinical findings similar to those of the impingement syndrome
- Focal tenderness when the area of the bursa is palpated
Clinical features of olecranon bursitis:
- Pain, swelling, and warmth at the location of the olecranon bursa on the extensor surface of the elbow
- Bursa may be fluctuant and full
- Typically, elbow extension is normal but flexion may be limited
- Can be secondary to: trauma, rheumatoid arthritis (RA), crystalline arthropathies (gout, calcium pyrophosphate dihydrate deposition disease [CPPD]), dialysis, or infection [frequently caused by a break in the surrounding skin])
Clinical presentation of trochanteric bursitis:
- Patients complain of “hip pain.” When asked to localize the pain, they point to the lateral aspect of the pelvis, with the area of greatest pain typically overlying the greater trochanter on the femur. Pain is exacerbated by lying on the affected side, walking, climbing stairs, rising from a seated position, and external rotation and abduction of the hip. Iliotibial band (ITB) tightness and leg length discrepancy predisposes a person to develop trochanteric bursitis.
Clinical presentation of retrocalcaneal (Achilles) bursitis:
- Heel pain
- Fullness or swelling proximal and anterior to the insertion of the Achilles tendon into the calcaneus
- Pain on palpation of the bursa