Bursitis

A bursa is a tiny sac filled with fluid that serves as a lubricant to minimize friction between body tissues. When a bursa swells, this condition is called bursitis. There are a total of 160 bursae in the human body, and the majority of them are located in large joint regions (e.g., shoulders, elbows, hips, knees).

Causes

An inflamed bursa can result from an injury, infection (uncommon in the shoulder), or a rheumatic condition. Something as seemingly harmless as unloading a bag of groceries from a vehicle, scraping a knee on the pavement, or inflammation of an elbow bursa due to gout crystals are all examples of how a bursa can become inflamed.

Diagnosis

Bursitis is usually characterized by targeted pain or swelling and tenderness, especially when the tissue in the vicinity of the bursitis is in motion. When bursitis has become a chronic condition, an x-ray exam can expose calcifications in the bursa that verify its recurrence.

Treatment

Treatment of bursitis is chosen based on whether an infection is present. Uninfected bursitis is dealt with by icing, resting, and taking anti-inflammatory and pain medicine. In rare cases, the bursa fluid may need to be extracted using a sterile needle and syringe. A physician will perform this procedure known as aspiration right at the office. Once removed, the fluid may be shipped to a lab for extensive testing. Bursitis that does not involve an infection can be treated with a shot of cortisone directly into the swollen bursa. Sometimes, aspiration and a cortisone injection will be executed on the same day to quickly minimize the amount of swelling in the bursa.

Infectious, or septic, bursitis demands a more intensive treatment program after the bursal fluid is tested in the lab for microbes that set off the infection. Curing septic bursitis requires antibiotics that may sometimes be administered through an IV. It may be necessary to repeatedly aspirate the inflamed fluid. In extreme cases, a bursectomy, or surgical removal of the infected bursa sac, may be mandatory. Once the operational wound has healed, normal functionality of the joint is usually restored.

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