Bursitis

Bursitis is an inflammatory disease of the bursae (fluid-filled sacs) around the joints and tendons; belongs to the group of extra-articular rheumatism.

Pathogenesis

 * The causes are not exactly known,
 * the share of mechanical factors (overload, direct pressure on the stock exchange) is assumed,
 * infectious bursitis is most often caused by Staphylococcus aureus + more often in immunodeficient patients (diabetes mellitus, rheumatoid arthritis, alcoholism, etc.).

Classification

 * aseptic bursitis,
 * infectious (septic) bursitis (more often non-specific).

Diagnosis

 * Simple for superficial bursitis x deeper localizations + more complicated when the neighboring tendons are affected,
 * clinical picture: pain, painful movement, dysfunction, redness, palpable pain + fluid fluctuations,
 * temperature + increase in inflammatory markers (septic bursitis), puncture of the inflamed bursa + aspiration of effusion,
 * deep stock market we prove by ultrasound, CT or MRI.

Therapy

 * Acute aseptic bursitis: puncture + local application of corticoids, non-opioid analgesics locally / general; after managing acute inflammation physiotherapy; persistent / extensive bursitis → extirpation of an inflamed, often hypertrophic bursae,
 * septic bursitis: corticoids should not be used; after puncture of purulent / severely turbid effusion, use antibiotics orally or intravenously; local anti-inflammatory bandages; in failure of the conservative therapy, chronic recurrent bursitis or infection caused by resistant microorganisms - surgical treatment.