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Bursitis

Bursitis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Bursae are synovial fluid-filled sacs:
    • ∼150 are located between bones, ligaments, tendons, muscles, and skin.
  • They provide lubrication to reduce friction during movement.
  • Bursitis is inflammation of a bursa caused by trauma and overuse, infection, crystal deposition, or systemic disease.
  • Chronic bursitis can lead to proliferative changes in the bursa.
  • Commonly affected sites:
    • Shoulder (subacromial)
    • Elbow (olecranon): Usually secondary to trauma
    • Hip (greater trochanter, ischial, iliopsoas): More common in elderly
    • Knee (prepatellar and pes anserine): Secondary to trauma or arthritis
    • Foot (calcaneal): Almost always secondary to improperly fitting shoes/heels

Etiology

  • Trauma (most common cause):
    • Specific traumatic event or repetitive use of associated joints
  • Infection: Secondary to direct penetration; may be obvious or microscopic:
    • Higher risk with diabetes, chronic alcohol abuse, uremia, gout, immunosuppression
    • 90% caused by Staphylococcus spp.
  • Crystal deposition: Calcium phosphate, urate
  • Systemic disease: Rheumatoid arthritis, gout, ankylosing spondylitis, psoriatic arthritis, lupus, rheumatic fever

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Citation

Rosen, Peter, et al., editors. "Bursitis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307597/0.1/Bursitis.
Bursitis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307597/0.1/Bursitis. Accessed June 18, 2019.
Bursitis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307597/0.1/Bursitis
Bursitis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 18]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307597/0.1/Bursitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bursitis ID - 307597 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307597/0.1/Bursitis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -