Septic Bursitis
Firza Alexander Gronthoud in Practical Clinical Microbiology and Infectious Diseases, 2020
Bursitis is the term used to describe inflammation of a bursa. Bursae are fluid-filled sacs lined by synovial tissue and filled with synovial fluid, located at points of friction between bone and surrounding soft tissue. Their function is to cushion and decrease friction between these surfaces during movement to allow your joints to move with ease. There are over 150 such bursae in the body and they are located both superficially (in the subcutaneous tissue) and deep (below the fascia). Commonly affected superficial sites include the olecranon, prepatellar and infrapatellar bursae. Deep sites are less affected and include the iliopsoas, popliteal and subacromial as examples. When bursitis is present, the inflamed sac impairs movement and results in local pain, tenderness and swelling. Septic, or infectious, bursitis is less common than non-septic bursitis in causing this inflammation.
Chronic joint pain
Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen in Clinical Pain Management, 2008
Soft-tissue disorders of the ankle include Achilles tendinitis, which is generally associated with repetitive trauma due to excessive use of the calf muscles during sporting activities. There may be an associated Achilles bursitis, which can also arise spontaneously or in association with a systemic arthropathy such as RA. One of the most common causes of pain around the heel is plantar fasciitis, which generally also results from repetitive microtrauma with risk factors being obesity, athletics, and poor footwear.172 The disorder may coexist with subcalcaneal bursitis.
Intra-articular and local soft-tissue injections
Harald Breivik, William I Campbell, Michael K Nicholas in Clinical Pain Management, 2008
Olecranon bursitis is usually traumatic. It causes pain, tenderness, and swelling over the point of the elbow. If traumatic, the aspirated fluid is clear, slightly cloudy, or blood stained. It is occasionally due to an inflammatory arthritis or gout when the fluid is cloudy. If it is bacterial there is usually cellulitis and the fluid is purulent. If infection has been excluded, a local corticosteroid injection directly into the cavity helps. Infective bursitis requires antibiotics.
Predicting the risk of relapse in polymyalgia rheumatica: novel insights
Published in Expert Review of Clinical Immunology, 2021
Diana Prieto-Peña, Santos Castañeda, Belén Atienza-Mateo, Ricardo Blanco, Miguel A. González-Gay
Polymyalgia rheumatica (PMR) is a common inflammatory disease in people over 50 years of age of Northern European descent [1,2,3]. It is characterized by severe pain affecting the shoulder girdle and proximal arms bilaterally. Pain and stiffness involving both the neck and the pelvic girdle, and the proximal thighs are also common. Patients complain of morning stiffness, which generally lasts for more than 45 to 60 minutes. The onset of symptoms usually begins abruptly, usually within a few days [1][61][62]. In some cases, symptoms get worse in the morning and progressively improve during the day. Pain and stiffness worsen after rest or when the patient is inactive for a long period [1]. Activities of daily living, such as dressing, or getting out of a chair, cause severe pain in the patients. Pain at night, malaise, fatigue, low-grade fever, anorexia, and weight loss are not uncommon [1]. Physical examination shows that the active motion of the shoulders is limited because of pain. It may also be observed when the motion of the neck or the hips is elicited. Loss of strength is not common but pain to palpation of the muscles may be observed. Bursitis and synovitis in the affected areas appear to be the reason for the musculoskeletal symptoms [2]. Laboratory findings are not specific. In most cases, patients have elevated acute-phase reactants, such as erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) [1,2]. Mild anemia and thrombocytosis may also be found. However, patients showing low elevation of acute-phase reactants or even normal values of ESR have been described [4,5].
Bilateral ultrasound findings in patients with unilateral subacromial pain syndrome
Published in Physiotherapy Theory and Practice, 2022
Anna Eliason, Marita Harringe, Björn Engström, Kerstin Sunding, Suzanne Werner
Despite the fact that bursitis and PTTs were more evident in the affected shoulder, abnormalities were found in almost 90% of the patients´ asymptomatic shoulder. This high rate is in concert with a detailed description of US findings in asymptomatic shoulders in males (Girish et al., 2011). They reported abnormalities in 96% of their patients with the most common finding being bursal thickening. This is similar to the present study, where bursitis was shown in 90% of the symptomatic shoulder and 74% of the asymptomatic shoulder. The subacromial bursa has been suggested to play a key role when it comes to generate pain in patients with SAPS (Chillemi et al., 2016; Rahme, Nordgren, Hamberg, and Westerberg, 1993). Although, yet not proven, presence of neovascularity has been mentioned as another theory of pain (Lewis et al., 2009).
Clinical and immunologic differences in cellulitis vs. pseudocellulitis
Published in Expert Review of Clinical Immunology, 2021
Michael Goldenberg, Henry Wang, Trent Walker, Benjamin H Kaffenberger
Bursitis is an inflammation of one or more bursae, fluid-filled synovial pouches that reduce friction between bones, tendons, and skin [107]. The most common cause is repeated microtrauma, but other etiologies include acute trauma or hemorrhage, septic bursitis, and inflammation from conditions like rheumatoid arthritis or gout. Bursitis can present with pain, erythema, decreased range of motion, and bursal enlargement, along with leukocytosis, fever, and warmth. Olecranon and prepatellar bursitis are the most common sites of repeated microtrauma bursitis, and they can become secondarily infected [107]. Bursal trauma increases local blood flow, allowing for migration of leukocytes and increasing synovial cell fluid production, thus establishing a proinflammatory environment [107a]. This environment can become colonized by bacteria via direct seeding, often associated with overlying soft tissue infections, and less commonly by hematogenous spread [107a]. Septic bursitis is most often caused by Staphylococcus aureus, responsible for up to 85% of cases [108a-112]. An ultrasound can differentiate bursitis from cellulitis, and bursal fluid aspirate analysis can distinguish septic bursitis from noninfectious causes, such as gout or pseudogout [108–111, 107a]. A microscopic exam of the bursal fluid is likely to show an inflammatory cocktail of interleukins, TNF-alpha, and cyclooxygenases [107a]. Treatment depends on the type of bursitis, with compression, analgesics, and ice being used for noninflammatory causes, antibiotics used for septic bursitis, and management of the underlying condition for inflammatory causes of bursitis [107].
Related Knowledge Centers
- Acromion
- Bone
- Inflammation
- Muscle
- Synovial Membrane
- Tendon
- Patella
- Synovial Bursa
- Synovial Fluid
- Calcaneus