Difference between revisions of "Bursitis" - New World Encyclopedia

	Bursitis; Classification and external resources
	Bursitis of the Elbow
ICD-10	M71.9
ICD-9	727.3
DiseasesDB	31623
MedlinePlus	000419
eMedicine	emerg/74
MeSH	D002062

Latest revision as of 03:54, 2 April 2008

Bursitis is the inflammation of one or more bursae, the fluid-filled sacs that rest adjacent to tendons, bones, and other tissues and create a smooth gliding surface and cushion. For example, bursae are located adjacent to tendons in elbow, shoulder, ankle, knee, heel, and hip. When bursitis takes hold, perhaps due to overuse, injury, or infection, the movement that relies on the inflamed bursa becomes rough and painful.

Bursitis is usually a temporary condition that causes pain and may restrain motion, and in chronic can lead to muscle deterioration; it generally does not cause deformity. It is common among people who are repeatedly using a limb or using it with excessive pressure, such as in baseball, tennis, running, shoveling snow, house painting, and so forth. The appearance of bursitis reflects on how harmoniously the human body normally works, allowing the muscles, tendons, and bones to interact seamlessly because of these small sacs.

Bursitis may be associated with other diseases, such as arthritis, thyroid disease, and diabetes (NYPH 2007).

Overview

Within the knee joint: bursae visible top right and bottom right

A bursa (plural bursae or bursas) is a small, closed, fluid-filled sac that is composed of white fibrous tissue. Bursae rest at the points where internal functionaries, like muscles and tendons, slide across bone. Bursae are found around almost every major joint of the body, providing a cushion between bones and tendons and/or muscles around the joint, and acting as a smooth and almost frictionless gliding surface as they move back and forth across each other. With hundreds of them throughout the body, bursae provide this surface for all motion, making movement normally painless.

Bursitis is the inflammation of one or more of these bursae, or small sacs of synovial fluid. Inflammation is a localized protective response of a body's living tissue to injury, infection, irritation, or allergy. Inflammation is characterized by the following quintet: Redness (rubor), heat (calor), swelling (tumor), pain (dolor), and dysfunction of the organs involved (functio laesa).

When bursitis occurs, the individual can experience pain, localized tenderness, and limited motion, as well as swelling and redness if the inflamed bursa is close to the surface (NYPH 2007). Movement of tendons and muscles over the inflamed bursa causes it to become more inflamed, perpetuating the problem. In chronic bursitis, there may be repeated attacks of pain, tenderness, and swelling, possibly leading to deterioration of the muscles (NYPH 2007).

The major bursae are located near the large joints, such as shoulders, hips, elbows, and knees (NYPH 2007). These tend to be the most common areas affected with bursitis.

Causes

Bursitis is commonly caused by repetition of movement or excessive pressure. Elbows and knees are the most commonly affected because they are rested upon more than many parts of the body with bursae and they also get the most repetitive use. Individuals that are overusing a limb or using it incorrectly, or that are in poor physical condition and with bad postures are at risk of developing bursitis (NYPH 2007). When there is compression of the bursa on a regular basis, such as a person who sleeps on the side and places significant pressure on the hip or shoulder for a long time, the person may become at risk of bursitis when continuing movement of this compressed area (BS 2005).

The other main cause of bursitis is traumatic injury, which can cause swelling of the bursae. The swelling itself causes irritation because the sac will no longer fit in the small area between the bone and the functionary. When the bone begins to increase pressure on the bursa, bursitis ensues.

Infection can be a probable cause as well (NYPH 2007). Inflammation of bursae can also be caused by other inflammatory conditions, such as rheumatoid arthritis. Scoliosis can also be a cause of bursitis of the shoulders, although this is rare.

Types

Among the more common types of bursitis are the following.

Kneecap bursitis. This bursitis is medically known as prepatellar bursitis and also called housemaid's knee. One of several types of bursa in the knee is known as the prepatellar bursa, and is located in front of the kneecap adjacent to the attachment of the patellar tendon (UMHS 2005). This may result from kneeling on a hard or raised surface for long periods, such as maids cleaning floors on their knees, or skilled laborers such as carpet layers or plumbers who are on their knees often (NYPH 2007). It is also common among wrestlers, from their knees rubbing on the mats, or among volleyball players who are diving onto the floor for the ball (UMHS 2005).

Knee bursitis. Known medically as pes anserine bursitis, or also commonly as goosefoot bursitis, this affects the pes anserine bursa located on the inner side of the knee below the knee joint, between the shin bone and the three tendons of the hamstring muscles that attach to the shin bone (tibia) (UMHS 2005; NYPH 2007). This might result from lack of stretching before exercise, out-turning of the knee or lower leg, being overweight, or arthritis, and is also common among swimmers who do the breaststroke (UMHS 2005; NYPH 2007).

Elbow bursitis. Known medically as olecranon bursitis and also nicknamed student's elbow, this affects the olecranon bursa located between the skin and bones of the elbow (NYPH 2007). This results from repeated pressure on the point of the elbow, such as leaning on a hard surface, as on a table or desk for a long time.

Anterior Achilles tendon bursitis. Also called Albert's disease, this is characterized by inflammation of the bursa located in front of the attachment of the tendon to the heel, caused by extra strain on the Achilles tendon, such as injury or shoes with rigid back support (NYPH 2007).

Posterior Achilles tendon bursitis. Otherwise known as Haglund's deformity, this involves inflammation of bursa located between the skin of the heel and the Achilles tendon, which attaches the calf muscles to the heel (NYPH 2007). This commonly results from a type of walking, such as among young women, whereby the soft heel tissue is pushed to the hard, back support of a shoe.

Hip bursitis. Known medically as trochanteric bursitis, this involves inflammation of the trochanteric bursa, which is located on the outer, upper area of the thigh, over the greater trochanger (which is a bump on the outerside of the upper part of the femur (UMHS 2005). It may be a result of injury, overuse, arthritis, spinal abnormalities, or surgery, and may occur with running, walking, or bicycling (UMHS 2005; NYPH 2007). This type of bursitis is also more common among women, middle-aged people, and older people (NYPH 2007).

Shoulder bursitis. This results from inflammation of the shoulder bursa, such as with sports with overhead movements (swimming, tennis, baseball, throwing) or activities such as painting and carpentry (UMHS 2005).

Buttocks bursitis. This involves an inflamed bursa over the bone in one's buttocks, perhaps from sitting on a hard surface for a long period, such as from bicycling (Mayo 2007).

Symptoms and diagnosis

The symptoms of bursitis can be as varied as the causes and types of bursitis. It can range from an achy pain and stiffness in the local area of the joint to a burning sensation in the area surrounding the whole joint with the inflamed bursa. The pain usually escalates during and after activity, with the bursa and the surrounding joint area becoming stiffer the following day.

Apart from pain, one finds localized tenderness and limited motion to be common among people who have bursitis. Swelling and redness may occur if the inflamed bursa is close to the surface (NYPH 2007). Repeated attacks of pain, swelling, and tenderness, possibly leading to the deterioration of muscles and a limited range-of-motion, is a case of chronic bursitis.

Firstly, an analysis of complete medical history and physical examination is mandatory. As the symptoms of bursitis resemble other medical conditions or problems, an accurate diagnosis is important. So other intensive diagnostic procedures are also employed. A sample of fluid from the bursa is obtained to rule out infections and to find the cause of the bursitis. Other tests that may be run are x-rays, computed tomography scan (CT or CAT scan), magnetic resonance imaging (MRI), anthrogram to provide evidence of a tear, opening, or blockage, and aspiration to rule out infection or gout as causes (NYPH 2007).

Treatment and prevention

Treatment depends on whether or not infection is involved, and the causes and symptoms. A common treatment is rest for the affected area, reducing swelling by ice, use of NSAIDs (nonsteroidal, anti-inflammatory drugs) to reduce inflammation and relieve pain, using a compression wrap to support and protect the bursa, elevating the affected area, and using topical pain relievers (NYPH 2007; Mayo 2007). Cortisone injections may be used, as well as physical therapy. In the case of infection, antibiotics may be used, and in worst case scenarios, surgical drainage and removal of the infected bursa (bursectomy) (NYPH 2007).

Prevention can be aided by regular stretching exercises, which can loosen the muscles and lengthen tendon connections around the bursa; relaxation techniques can also help reduce pressure on the bursa. Protective equipment, such as knee pads, can reduce injury and pressure on the joint area. Immediate treatment can reduce the risk of the bursitis becoming more severe.

References
ISBN links support NWE through referral fees

Bursitis.org (BS). 2005. Bursitis. Retrieved December 16, 2007.
Mayo Clinic. 2007. Bursitis. Retrieved December 16, 2007.
New York-Presbyterian Hospital (NYPH). 2007. Bursitis. Retrieved December 15, 2007.
University of Michigan Health System (UMHS). 2005. Bursitis. Retrieved December 15, 2007.

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@@ Line 1: / Line 1: @@
-{{Claimed}}{{Contracted}}
+{{Approved}}{{Images OK}}{{Submitted}}{{Paid}}{{copyedited}}
 {{Infobox_Disease |
    Name          = {{PAGENAME}} |
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    MeshID        = D002062 |
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-'''Bursitis''' is the [[inflammation]] of one or more [[Bursa (anatomy)|bursae]].
+'''Bursitis''' is the [[inflammation]] of one or more [[Bursa (anatomy)|bursae]], the fluid-filled sacs that rest adjacent to [[tendon]]s, [[bone]]s, and other tissues and create a smooth gliding surface and cushion. For example, bursae are located adjacent to tendons in elbow, shoulder, ankle, knee, heel, and hip. When bursitis takes hold, perhaps due to overuse, injury, or infection, the movement that relies on the inflamed bursa becomes rough and painful.
-wiki:'''Bursitis''' is the [[inflammation]] of one or more [[Bursa (anatomy)|bursae]], or small sacs of [[synovial fluid]], in the body. Bursae rest at the points where internal functionaries, like [[muscle]]s and [[tendon]]s, slide across [[bone]]. Healthy bursae create a smooth and almost frictionless gliding surface. With hundreds of them throughout the body they provide this surface for all motion, making movement normally painless. When bursitis takes hold, however, movement that relies on the inflamed bursa becomes rough and painful. Movement of tendons and muscles over the inflamed bursa causes it to become more inflamed, perpetuating the problem.
-EM A bursa (plural bursae) is a closed, fluid-filled sac that surrounds joints or [[tendon]]s. It functions as a cushion and gliding surface to reduce friction between [[muscle]]s, tendons, and [[bone]]s as they move back and forth across each other. The major bursae are located adjacent to the tendons near the large joints, like shoulders, elbows, hips, and knees.
-WIki: A '''bursa''' (plural ''bursae'' or ''bursas''; [[Latin]]: ''Bursa synovialis'') is a small fluid-filled sac made of white fibrous tissue and lined with synovial membrane. It provides a cushion between bones and tendons and/or muscles around a joint; bursae are filled with synovial fluid and are found around almost every major joint of the body; when they become inflamed, the condition is called bursitis.
-EM Bursitis, an inflammation of a bursa, is usually a temporary condition that may restrain motion, and it generally does not cause deformity. It is common among people in sports such as [[baseball]], [[tennis]], [[racquetball]], and running. But even everyday household jobs such as yard work, shoveling dirt or snow, and house painting can cause bursitis.
-Bursitis is often associated with other diseases, such as arthritis, thyroid disease, and diabetes.
+Bursitis is usually a temporary condition that causes [[pain]] and may restrain motion, and in chronic can lead to muscle deterioration; it generally does not cause deformity. It is common among people who are repeatedly using a limb or using it with excessive pressure, such as in [[baseball]], [[tennis]], running, shoveling snow, house painting, and so forth. The appearance of bursitis reflects on how harmoniously the [[human body]] normally works, allowing the muscles, tendons, and bones to interact seamlessly because of these small sacs.
+Bursitis may be associated with other [[disease]]s, such as [[arthritis]], thyroid disease, and [[diabetes]] (NYPH 2007).
 ==Overview==
 [[Image:Gray350.png|thumb|Within the knee joint: bursae visible top right and bottom right]]
+A '''bursa''' (plural ''bursae'' or ''bursas'') is a small, closed, fluid-filled sac that is composed of white fibrous tissue. Bursae rest at the points where internal functionaries, like [[muscle]]s and [[tendon]]s, slide across [[bone]]. Bursae are found around almost every major joint of the body, providing a cushion between bones and tendons and/or muscles around the joint, and acting as a smooth and almost frictionless gliding surface as they move back and forth across each other. With hundreds of them throughout the body, bursae provide this surface for all motion, making movement normally painless.
-Bursa
+Bursitis is the [[inflammation]] of one or more of these [[Bursa (anatomy)|bursae]], or small sacs of [[synovial fluid]]. Inflammation is a localized protective response of a body's living tissue to [[injury]], [[infection]], [[irritation]], or [[allergy]]. Inflammation is characterized by the following quintet: Redness ''(rubor)'', heat ''(calor)'', swelling ''(tumor)'', [[pain]] ''(dolor)'', and dysfunction of the organs involved ''(functio laesa)''.
-A bursa (plural bursae) is a closed, fluid-filled sac that surrounds joints or [[tendon]]s. It functions as a cushion and gliding surface to reduce friction between [[muscle]]s, tendons, and [[bone]]s as they move back and forth across each other. The major bursae are located adjacent to the tendons near the large joints, like shoulders, elbows, hips, and knees.
-A '''bursa''' (plural ''bursae'' or ''bursas''; [[Latin]]: ''Bursa synovialis'') is a small fluid-filled sac made of white fibrous tissue and lined with synovial membrane. It provides a cushion between bones and tendons and/or muscles around a joint; bursae are filled with synovial fluid and are found around almost every major joint of the body; when they become inflamed, the condition is called bursitis.
-Inflammation
+When bursitis occurs, the individual can experience pain, localized tenderness, and limited motion, as well as swelling and redness if the inflamed bursa is close to the surface (NYPH 2007). Movement of tendons and muscles over the inflamed bursa causes it to become more inflamed, perpetuating the problem. In chronic bursitis, there may be repeated attacks of pain, tenderness, and swelling, possibly leading to deterioration of the muscles (NYPH 2007).
+The major bursae are located near the large joints, such as shoulders, hips, elbows, and knees (NYPH 2007). These tend to be the most common areas affected with bursitis.
 ==Causes==
-Bursitis is commonly caused by repetition of movement or excessive pressure. [[Elbow-joint|Elbow]]s and [[knee]]s are the most commonly affected because they are rested upon more than many parts of the body with bursae and they also get the most repetitive use. Inflammation of bursae can also be caused by other inflammatory conditions such as [[rheumatoid arthritis]]. [[Scoliosis]] can also be a cause of bursitis of the shoulders although this is rare. Shoulder bursitis is more commonly due to overuse of the shoulder joint and muscles. <ref>{{cite web|url=http://www.treatment-for.com/shoulder-bursitis-treatment.htm|title=Shoulder Bursitis}}</ref>
+Bursitis is commonly caused by repetition of movement or excessive pressure. [[Elbow-joint|Elbow]]s and [[knee]]s are the most commonly affected because they are rested upon more than many parts of the body with bursae and they also get the most repetitive use. Individuals that are overusing a limb or using it incorrectly, or that are in poor physical condition and with bad postures are at risk of developing bursitis (NYPH 2007). When there is compression of the bursa on a regular basis, such as a person who sleeps on the side and places significant pressure on the hip or shoulder for a long time, the person may become at risk of bursitis when continuing movement of this compressed area (BS 2005).
 The other main cause of bursitis is traumatic injury, which can cause swelling of the bursae. The swelling itself causes irritation because the sac will no longer fit in the small area between the bone and the functionary.  When the bone begins to increase pressure on the bursa, bursitis ensues.
+[[Infection]] can be a probable cause as well (NYPH 2007). Inflammation of bursae can also be caused by other inflammatory conditions, such as [[rheumatoid arthritis]]. [[Scoliosis]] can also be a cause of bursitis of the shoulders, although this is rare.
 ==Types==
+Among the more common types of bursitis are the following.
-==Causes and types==
+*'''Kneecap bursitis.''' This bursitis is medically known as '''prepatellar bursitis''' and also called '''housemaid's knee'''. One of several types of bursa in the knee is known as the prepatellar bursa, and is located in front of the kneecap adjacent to the attachment of the patellar tendon (UMHS 2005). This may result from kneeling on a hard or raised surface for long periods, such as maids cleaning floors on their knees, or skilled laborers such as carpet layers or plumbers who are on their knees often (NYPH 2007). It is also common among wrestlers, from their knees rubbing on the mats, or among volleyball players who are diving onto the floor for the ball (UMHS 2005).
-EM
-Individuals in poor physical condition and with bad postures are at risk of developing bursitis.
-Injury or overuse is what usually causes bursitis. It may also occur by using an affected limb incorrectly. [[Infection]] can be a probable cause as well.
-Another way that bursitis occurs is when compression of the bursa happens on a regular basis, such as a side sleeper who places a lot of shoulder or hip pressure on the area when they lay down for long periods. In this case, it would not take too much movement of this already compressed area to cause friction of the bursa.
-The type of bursitis that affects each person varies, as it strikes the areas which are overused or on which pressure is applied the most:
-*'''Kneecap bursitis''', which is also called ''housemaid's knee'' and is medically known as ''prepatellar bursitis'', results from kneeling on a hard or raised surface for long periods. This type of bursitis is common among skilled laborers like carpet layers and plumbers, who need to sit on their knees a lot.
-* '''Elbow bursitis''', known medically as ''olecranon bursitis'' and also nicknamed ''student's elbow'', results from repeated pressure on the point of the elbow. Inflammation of the olecranon bursa located between the [[skin]] and [[bone]]s of the elbow is what causes this type of bursitis. It often occurs when there is constant pressure on the elbow doing something as simple as leaning on a hard surface, such as someone leaning on a table or desk for a long time.
-* '''Knee bursitis''', known also as ''goosefoot bursitis'' or ''Pes Anserine bursitis'', affects the bursa located between the shin bone and the three tendons of the hamstring muscles, on the inside of the knee. This is usually caused by lack of stretching before exercise, tight hamstring muscles, being overweight, [[arthritis]], or out-turning of the knee or lower leg.
-* '''Anterior Achilles tendon bursitis''', also called ''Albert's disease'', is caused by extra strain on the [[Achilles tendon]], such as injury, [[disease]], or shoes with rigid back support. It is characterized by [[inflammation]] of the bursa located in front of the attachment of the tendon to the heel.
-* '''Posterior Achilles tendon bursitis''', otherwise called ''Haglund's deformity'', is inflammation of bursa located between the skin of the heel and the Achilles tendon, which attaches the calf muscles to the heel. Aggravated by a type of walking that presses the soft heel tissue to the hard, back support of a shoe, this type of bursitis occurs mostly among young women.
-*'''Hip bursitis''', or ''trochanteric bursitis'', is often the result of injury, overuse, spinal abnormalities, arthritis, or [[surgery]]. This type of bursitis is also more common among women, apart from middle-aged and older people.
-==Symptoms==
-Symptoms can vary from an ache and stiffness in the local area of the joint, to a burning that surrounds the whole joint around the inflamed bursa. With this condition, the pain is usually worse during and after activity, and the bursa and surrounding joint area can become stiffer the following day.
-==Signs and symptoms==
-EM
-The symptoms of Bursitis can be as varied as the causes and types of bursitis. It can range from an achy [[pain]] and stiffness to even a burning sensation on the area surrounding the joint with the inflamed bursa. The pain usually escalates during and after activity, with the bursa and the surrounding joint area becoming stiffer the following day.
-Apart from pain, one finds localized tenderness and limited motion to be common among people who have bursitis. Swelling and redness also occurs if the inflamed bursa is close to the surface.
-Repeated attacks of pain, swelling, and tenderness, leading to the deterioration of muscles and a limited range-of-motion, is a case of chronic bursitis.
-==Diagnosis==
-Firstly, an analysis of complete medical history and physical examination is mandatory. As the symptoms of bursitis resemble other medical conditions or problems, an accurate diagnosis is important. So other intensive diagnostic procedures are also employed.
-A sample of fluid from the bursa is obtained to rule out infections and to find the cause of the bursitis. And apart from x-rays and blood tests, other tests may also be required:
-• Computed tomography scan ( CT or CAT scan)
-• Magnetic resonance imaging (MRI)
-• Arthrogram to provide evidence of a tear, opening, or blockage.
-• Aspiration to rule out infection or gout as causes.
-Prevention
-Bursitis can be prevented by doing stretching exercises regularly, especially before and after heavy workouts. Stretching muscles lengthens tendon connections around the bursa, allowing less friction to the tendon/bursa/bone connections.
-Relaxation techniques also help to reduce pressure on the bursa and to keep it from losing its natural lubrication.  Wearing a protective pad can also help avoid pressure and injury to the joint. When bursitis does occur, it is important to treat it immediately, and thereby prevent it from reaching a stage that is more severe.
-In bursitis, the bursa is inflamed but not infected. If the swelling spreads despite treatment or if you develop fever, chills, or increased warmth, these are signs of possible infection.
-Treatment
-Treatment for this condition is determined by several factors:
-• Age, overall health and medical history
-• Extent of the condition
-• Patient’s tolerance for specific medications, procedures, or therapies
-• Expectations for the course of the condition
-Personal preferences and the possibility of an infection also play a role in treatment. The treatment for bursitis also depends on whether or not it involves infection.
-In the case of aseptic bursitis - a non-infectious condition, treatment may include:
-Rest
-Do not put any pressure on the sore and swollen area until the swelling subsides. Rest the affected area such as the shoulder, elbow, knee, or hip. And wait 3 to 6 weeks before returning to the sport or task that originally caused your condition.
-Ice
+* '''Knee bursitis.''' Known medically as '''pes anserine bursitis,''' or also commonly as '''goosefoot bursitis,''' this affects the pes anserine bursa located on the inner side of the knee below the knee joint, between the shin bone and the three tendons of the hamstring muscles that attach to the shin bone (tibia) (UMHS 2005; NYPH 2007). This might result from lack of stretching before exercise, out-turning of the knee or lower leg, being overweight, or [[arthritis]], and is also common among swimmers who do the breaststroke (UMHS 2005; NYPH 2007).
-Put an ice pack on the area for 20 to 30 minutes 3 or 4 times a day to help relieve pain. But it important not to do this more often, as it can constrict the blood vessels and further stiffen the joint area.
-Compression
+* '''Elbow bursitis.''' Known medically as '''olecranon bursitis''' and also nicknamed '''student's elbow,''' this affects the olecranon bursa located between the skin and bones of the elbow (NYPH 2007). This results from repeated pressure on the point of the elbow, such as leaning on a hard surface, as on a table or desk for a long time.
-Wear a compression wrap around the affected area such as the elbow or knee. It is important to support and protect the bursa by bracing any areas of the tendon that are being pulled on during use, as this will help stop bursa friction from occurring.
-The pressure on the bursa can also be reduced while sleeping by using a softer bed topper like a memory foam mattress pad or even getting a new mattress that is composed with memory foam or latex foam.  Memory foam and latex foam reduce compression because they are the only substances that conform with the bumps and curves of the body and can thereby reduce the pressure spot by more evenly disbursing the weight of the body.
+* '''Anterior Achilles tendon bursitis.''' Also called '''Albert's disease,''' this is characterized by [[inflammation]] of the bursa located in front of the attachment of the tendon to the heel, caused by extra strain on the [[Achilles tendon]], such as injury or shoes with rigid back support (NYPH 2007).
-Elevation
+* '''Posterior Achilles tendon bursitis.''' Otherwise known as '''Haglund's deformity,''' this involves inflammation of bursa located between the skin of the heel and the Achilles tendon, which attaches the calf muscles to the heel (NYPH 2007). This commonly results from a type of walking, such as among young women, whereby the soft heel tissue is pushed to the hard, back support of a shoe.
-While resting, keep the affected area at an elevation.
-Pain relief
+* '''Hip bursitis'''. Known medically as '''trochanteric bursitis''', this involves inflammation of the trochanteric bursa, which is located on the outer, upper area of the thigh, over the greater trochanger (which is a bump on the outerside of the upper part of the femur (UMHS 2005). It may be a result of injury, overuse, arthritis, spinal abnormalities, or [[surgery]], and may occur with running, walking, or bicycling (UMHS 2005; NYPH 2007). This type of bursitis is also more common among women, middle-aged people, and older people (NYPH 2007).
-Reducing bursa inflammation and soothing the pain of bursitis can be done topically with pain relievers containing anti-inflammatory agents. A topical formula with natural menthol will not only relieve pain, but also dilate the blood vessels. This allows for relief of the bursitis, without causing any stiffening of the tissue.
-Anti-inflammatory and pain medications such as ibuprofen or aspirin are usually prescribed. Cortisone injections can also reduce inflammation, but they are very caustic and can cause a weakening of the tissue structure and sometimes create more scar tissue.
+*'''Shoulder bursitis.''' This results from inflammation of the shoulder bursa, such as with sports with overhead movements (swimming, tennis, baseball, throwing) or activities such as painting and carpentry (UMHS 2005).
-Physical therapy
+*'''Buttocks bursitis.''' This involves an inflamed bursa over the bone in one's buttocks, perhaps from sitting on a hard surface for a long period, such as from bicycling (Mayo 2007).
-This may involve stretching and strengthening exercises. Also maintain your range of motion by moving the joint to help keep the joint from getting stiff.
-Soft tissue manipulation
+==Symptoms and diagnosis==
-Methods such as ultrasound and massage are also used to help break down the scar tissue in the tendon tissue and let the tendon and muscle regain normal flexibility. This can lessen the chance of further injury.
+The symptoms of bursitis can be as varied as the causes and types of bursitis. It can range from an achy [[pain]] and stiffness in the local area of the joint to a burning sensation in the area surrounding the whole joint with the inflamed bursa. The pain usually escalates during and after activity, with the bursa and the surrounding joint area becoming stiffer the following day.
-Ultrasound uses sound waves to increase circulation to the tissue and soften the scar tissue, allow it to break down further.  Ultrasound can also be used as phonophoresis to help topical pain and nutrient solutions reach further down into the tissues by transporting them with the sound waves.
+Apart from pain, one finds localized tenderness and limited motion to be common among people who have bursitis. Swelling and redness may occur if the inflamed bursa is close to the surface (NYPH 2007).
+Repeated attacks of pain, swelling, and tenderness, possibly leading to the deterioration of [[muscle]]s and a limited range-of-motion, is a case of chronic bursitis.
+Firstly, an analysis of complete medical history and physical examination is mandatory. As the symptoms of bursitis resemble other medical conditions or problems, an accurate diagnosis is important. So other intensive diagnostic procedures are also employed. A sample of fluid from the bursa is obtained to rule out infections and to find the cause of the bursitis. Other tests that may be run are [[x-ray]]s, computed tomography scan (CT or CAT scan), magnetic resonance imaging (MRI), anthrogram to provide evidence of a tear, opening, or blockage, and aspiration to rule out infection or gout as causes (NYPH 2007).
-In the case of septic bursitis - bursa that becomes infected with bacteria, treatment may also include:
+==Treatment and prevention==
-• Antibiotic medications
+Treatment depends on whether or not infection is involved, and the causes and symptoms. A common treatment is rest for the affected area, reducing swelling by ice, use of [[NSAID]]s (nonsteroidal, anti-inflammatory drugs) to reduce inflammation and relieve pain, using a compression wrap to support and protect the bursa, elevating the affected area, and using topical pain relievers (NYPH 2007; Mayo 2007). Cortisone injections may be used, as well as physical therapy. In the case of infection, [[antibiotic]]s may be used, and in worst case scenarios, surgical drainage and removal of the infected bursa (bursectomy) (NYPH 2007).
-• Repeated aspiration of the inflamed fluid
-• Surgical drainage and removal of the infected bursa sac (bursectomy)
-With treatment, the pain and swelling of bursitis usually clear up within 2 to 3 weeks. But the healing of the area continues and doesn't even peak until at least six weeks following the initial injury.
+Prevention can be aided by regular stretching exercises, which can loosen the muscles and lengthen tendon connections around the bursa; relaxation techniques can also help reduce pressure on the bursa. Protective equipment, such as knee pads, can reduce injury and pressure on the joint area. Immediate treatment can reduce the risk of the bursitis becoming more severe.
-This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together.  Scar tissue continues to form past six weeks in some cases and as long as a year in severe cases. After 6 months, if this condition persists, it is considered chronic.
-References
-Retrieved from:
-• http://wo-pub2.med.cornell.edu
-• http://www.med.umich.edu
-• http://www.bursitis.org
-==Examples==
-The most common examples of this condition are [[Prepatellar bursitis]], [[Trochanteric bursitis]], [[Olecranon bursitis]] and [[Subacromial bursitis]].
 ==References==
-<references/>
+* Bursitis.org (BS). 2005. [http://www.bursitis.org/ Bursitis]. Retrieved December 16, 2007.
+* Mayo Clinic. 2007. [http://www.mayoclinic.com/health/bursitis/DS00032/DSECTION=1 Bursitis]. Retrieved December 16, 2007.
-==External links==
+* New York-Presbyterian Hospital (NYPH). 2007. [http://www.nyp.org/health/orthopaedics_bursit.html Bursitis]. Retrieved December 15, 2007.
-*[http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=70 Bursitis information and treatment] from [[NHS Direct]]
+* University of Michigan Health System (UMHS). 2005. [http://www2.med.umich.edu/healthcenters/healthcenterservices_byclinickeyword.cfm?search_clinicdept=Physical%20Medicine%20and%20Rehabilitation&search_clinkeyword=Bursitis Bursitis]. Retrieved December 15, 2007.
-*[http://orthopedics.about.com/cs/sportsmedicine/a/blbursitis.htm General Bursitis Information] at [[About.com]]
-*[http://www.mayoclinic.com/health/bursitis/DS00032/DSECTION=1 Information from the] [[Mayo Clinic]]
-[[Category:Inflammations]]
-[[Category:Life sciences]]
+[[Category:Life sciences]][[Category:Health and disease]][[Category:Diseases]]
 {{credit|Bursitis|177358267|Bursa_(anatomy)|177426026}}


Bursitis Classification and external resources
Bursitis of the Elbow
ICD-10	M71.9
ICD-9	727.3
DiseasesDB	31623
MedlinePlus	000419
eMedicine	emerg/74
MeSH	D002062