Bursitis

Bursitis is an inflammation of the bursa. The bursa is a fluid filled sac that cushions and lubricates tendons and bones in a joint that rub against each other. Bursitis is painful and a nuisance, but not life-threatening, and mainly afflicts adults over the age of 40. The areas with joints that are most susceptible to bursitis are:


 * Elbow
 * Shoulder
 * Hip
 * Knee
 * Achilles tendon

Symptoms
Bursitis consists of pain, tenderness, or swelling that is localized around the bursa in a joint. It can also consist of pain associated with motion in the tissues around the infection. When observed, some cases of bursitis are occasionally accompanied by calcification in the bursa, normally where cases of bursitis are recurrent or chronic.

However, the most common symptom of bursitis is pain. The pain may build up gradually or suddenly appear in a very severe form, but it always accompanies bursitis. The most severe pain usually occurs when calcium deposits are present. In cases of bursitis in the shoulder, a loss of motion may be a sign that the bursa has been afflicted.

Causes
After an injury to a joint, the bursa can become inflamed due to infection, an underlying rheumatic condition, or because of the injury itself. For example, the bursa in the knee can become inflamed after scraping the knee on pavement or asphalt, the bursa in the knee has been known to get inflamed due to gout crystals, and even a simple action such as lifting a bag of groceries into a car can aggravate the shoulder joint and develop bursitis in the shoulder.

Bursitis can also develop through a series of repetitive, minor impacts on a specific area. Age is also a contributing factor to bursitis, as is the overuse of the joint. Finally, varying lengths in the bones the joint connects can eventually result in bursitis developing.

While these are not the only methods through which the bursa can be injured, bursitis always classifies as an inflammation of the bursa, and can refer to any number of the many bursa located in the joints of the body.

Diagnosis
In most cases, a diagnosis of bursitis can be done by a a family doctor, who may make a referral to a rheumatologist, a doctor that specializes in joint disorders. In order to make the diagnosis, the doctor may simply just need to look at the patient's medical history and perform a medical exam. However, if the affliction is in a deep bursae and not easily accessible for inspection, then several different techniques can be used to assist in the diagnosis. These techniques can include:


 * Arthrogram - An X-ray that is used to view bone structures following an injection of a contrast fluid in a joint area. If the fluid appears in an area that it shouldn't, the leak would give doctors information about a possible tear, opening, or blockage, which could suggest possible disease or injury.
 * Aspiration – This procedure involves the removal of fluid from the swollen bursa to exclude infection or gout as causes of bursitis.
 * Blood tests – A blood test includes a routine laboratory test that is performed to confirm or eliminate conditions other than bursitis.
 * Computed tomography scan (CT Scan) – A CT scan is an imaging device that uses a combination of x-rays and computer technology to produce images of the body that creates a 3-dimensional picture of the affected area.Because CT scans are so much more detailed than regular X-rays, they can help doctors make a more accurate diagnosis.
 * Magnetic resonance imaging (MRI) - This diagnostic procedure uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body and is helpful in identifying possible locations of bursitis.
 * Ultrasound – In the use of an ultrasound, high-frequency sound waves are used to create an image of the affected joint.
 * X-ray - This diagnostic test uses invisible electromagnetic energy beams to produce images of the inside of the body and project that image on a film.

While any one of these techniques would be helpful in a diagnosis of bursitis, none of them are truly necessary in a simple case. However, in the event of a deep-body affliction, they are most helpful.

Treatment
There are multiple treatments for bursitis; a few of them are:


 * Not performing activities that could further aggravate the injury.
 * Resting the area that has been injured.
 * Icing the injury on the day of the injury.
 * Taking over-the-counter drugs used to treat inflammation.

A doctor can also prescribe medicine that treats inflammation. Some of the most common types of drugs that are used are corticosteroids, or simply known as steroids. These work quickly to treat inflammation and the pain of the injury. In addition, steroids are some of the safest methods of treatment and can be injected directly to the site of the injury. However, about a third of people that take the steroids do not get complete relief from a single injection. Another disadvantage is that it is not safe to administer steroids to recurrent cases of bursitis. Physical therapy is another good choice of treatment, and the best results come from regimens including splinting and range-of-motion exercises. Surgery is very rarely needed, but is an option for cases that do not respond to the other treatments.

The treatment of any form of bursitis depends on whether or not it involves infection. Bursitis that is not infected can be treated with ice compresses, rest, and anti-inflammatory and pain medications, as stated earlier. Occasionally, it requires aspiration of the bursa fluid. This process involves removal of the fluid with a needle and syringe under sterile conditions and can be performed in a doctor's office. However, cases of infected bursitis require careful evaluation and aggressive treatment. Cases of infected bursitis bursitis require antibiotic therapy, sometimes through the use of an IV. Surgical drainage and removal of the infected bursa sac may eventually be necessary if the bursa does not respond to treatment. Generally, the joint that was affected by bursitis performs normally after the surgical wound heals.

Modern Study and Prevention
At this point in time, bursitis is simply an annoying factor in the lives of many adults. In fact, bursitis is most common in adults over the age of 40, but anyone can develop it. To help prevent bursitis, take note of how your body feels after performing activities. If there is no pain, gradually build upon the activity and allow yourself to do more, but with limited force and repetition. However, as common sense dictates, stop the activity if there is an unusual pain. Attempt the activity again later, and if the pain reoccurs, then do not attempt the activity again that day. If the pain begins to occur regularly, contact your doctor.

Videos
Information about bursitis.

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